nmpЖурнал им. Н.В. Склифосовского «Неотложная медицинская помощь»Russian Sklifosovsky Journal "Emergency Medical Care"2223-90222541-8017“N.V. Sklifosovsky Research Institute for Emergency Medicine”nmp-117Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL OBSERVATIONSПЕРЕЛОМЫ РЕБЕР И РАЗРЫВ ДИАФРАГМЫ С ФОРМИРОВАНИЕМ ТРАНСДИАФРАГМАЛЬНОЙ МЕЖРЕБЕРНОЙ ГРЫЖИ В РЕЗУЛЬТАТЕ СИЛЬНОГО КАШЛЯ (КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯ С ОБЗОРОМ ЛИТЕРАТУРЫ)FRACTURES OF THE RIBS AND THE DIAPHRAGMATIC RUPTURE WITH A FORMATION OF THE TRANSDIAPHRAGMATIC INTERCOSTAL HERNIA AS A RESULT OF SEVERE COUGHING (CLINICAL OBSERVATION WITH A REVIEW OF THE LITERATURE)ДаниелянШ. Н.DanielyanS. N.АбакумовМ. М.AbakumovM. M.МуслимовР. Ш.MuslimovR. S.ГаланкинаИ. Е.GalankinaI. E.ВилькА. П.VilkA. P.

научный сотрудник

отделение неотложной торакоабдоминальной хирургии 

aleksey.vilk.77@mail.ruНИИ скорой помощи имени Н.В. Склифосовского ДЗ г. Москвы, МоскваРоссияN.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Healthcare Department, MoscowRussian Federation201427032016044247Copyright © Даниелян Ш.Н., Абакумов М.М., Муслимов Р.Ш., Галанкина И.Е., Вильк А.П., 20162016Даниелян Ш.Н., Абакумов М.М., Муслимов Р.Ш., Галанкина И.Е., Вильк А.П.Danielyan S.N., Abakumov M.M., Muslimov R.S., Galankina I.E., Vilk A.P.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jnmp.ru/jour/article/view/117

РЕЗЮМЕ. Сильный кашель может привести к развитию ряда осложнений, в том числе разрыву диафрагмы и переломам ребер. В данном сообщении представлены два схожих редких клинических наблюдения: мужчины 48 и 74 лет с разрывом левой половины диафрагмы и переломами ребер в результате сильного кашля с формированием трансдиафрагмальной межреберной грыжи грудной стенки. В обоих наблюдениях имела место поздняя диагностика повреждений. Хирургическое лечение заключалось в пластике диафрагмы торакотомным доступом с использованием сетчатого импланта. Гистологическое исследование ребра в зоне повреждения в одном наблюдении выявило фиброзную остеодисплазию. Проанализированы данные литературы по этому редкому виду повреждений. 

ABSTRACT. Severe coughing might lead to development of a number of complications, including the diaphragmatic rupture and the ribs fractures. The report contains two similar rare clinical cases: male patients aged 48 and 74 years with transdiaphragmatic intercostal thoracic wall hernia after the rupture of the left half of the diaphragm and ribs fractures as a result of violent coughing. Both patients had a late diagnosis of injuries. Surgical therapy was performed via thoracotomy access using a mesh implant. histological study of the rib in the damaged area in one case detected fibrous osteodysplasia. The review of literature on this rare type of injury was analyzed. 

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The authors declare that there are no conflicts of interest present.