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Cáncer Requeno, A. Farreras Margenat, M. Homs Riera, Y. Boliart de San Félix" "autores" => array:4 [ 0 => array:4 [ "nombre" => "G." "apellidos" => "Cáncer Requeno" "email" => array:1 [ 0 => "md081112@uic.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Farreras Margenat" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Homs Riera" ] 3 => array:2 [ "nombre" => "Y." "apellidos" => "Boliart de San Félix" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Universitario Quirón Dexeus, Barcelona, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Fractura diafragmática vs. parálisis frénica secundaria a cirugía de citorreducción" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:2 [ 0 => array:1 [ "imagen" => "gr1.jpeg" ] 1 => array:1 [ "imagen" => "gr2.jpeg" ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Thoracoabdominal CT angiography. Elevated right hemidiaphragm (dashed line). Arrow showing tracheal carina.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 53-year-old female patient with diaphragm rupture vs. phrenic paralysis after debulking surgery with removal of diaphragmatic implants and pleural perforation. Postoperative CT angiography images are both clinically and scientifically important, since this complication has rarely been described in the literature.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We present the case of a patient with a history of endometrial neoplasia with peritoneal spreading scheduled for debulking and staging surgery, consisting of hysterectomy, double adnexectomy, omentectomy, appendectomy, pelvic and para-aortic lymphadenectomy, and resection of bilateral peritoneal, intestinal, and diaphragmatic implants. During surgery, the right diaphragm was perforated, causing a minor air leak; the defect was sutured. Forty-eight hours after surgery, the patient presented symptoms of progressive dyspnoea and right scapular pain, with low SatO<span class="elsevierStyleInf">2</span>. A chest and abdomen CT angiography (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) showed signs suggestive of right posterior diaphragmatic rupture pushing the liver into the thoracic cavity (dashed line) as far as the subcarinal space (black arrow), ipsilateral haemopneumothorax with no active bleeding, and passive atelectasis of the LLL, resulting in respiratory, but not hemodynamic, changes. Due to the patient's haemodynamic stability and oncological disease, we took a wait-and-see approach, and the symptoms ultimately subsided spontaneously.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0015" class="elsevierStylePara elsevierViewall">This study did not receive any financial support.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interests</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors have no conflict of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interests" ] 2 => array:2 [ "identificador" => "xack606245" "titulo" => "Acknowledgements" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Cáncer Requeno G, Farreras Margenat A, Homs Riera M, Boliart de San Félix Y. Fractura diafragmática vs. parálisis frénica secundaria a cirugía de citorreducción. Rev Esp Anestesiol Reanim. 2022. <span class="elsevierStyleInterRef" id="intr0005" href="https://doi.org/10.1016/j.redar.2021.03.015">https://doi.org/10.1016/j.redar.2021.03.015</span></p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:2 [ 0 => array:1 [ "imagen" => "gr1.jpeg" ] 1 => array:1 [ "imagen" => "gr2.jpeg" ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Thoracoabdominal CT angiography. Elevated right hemidiaphragm (dashed line). Arrow showing tracheal carina.</p>" ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack606245" "titulo" => "Acknowledgements" "texto" => "<p id="par0025" class="elsevierStylePara elsevierViewall">The authors would like to thank the Gynaecology Service and the Diagnostic Imaging Service for their help in the case.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/23411929/0000006900000004/v1_202205250609/S2341192922000634/v1_202205250609/en/main.assets" "Apartado" => array:4 [ "identificador" => "70433" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images of the month" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23411929/0000006900000004/v1_202205250609/S2341192922000634/v1_202205250609/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192922000634?idApp=UINPBA00004N" ]
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Vol. 69. Issue 4.
Pages 253-254 (April 2022)
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Vol. 69. Issue 4.
Pages 253-254 (April 2022)
Image of the month
Diaphragmatic fracture vs. phrenic paralysis after debulking surgery
Fractura diafragmática vs. parálisis frénica secundaria a cirugía de citorreducción
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G. Cáncer Requeno
, A. Farreras Margenat, M. Homs Riera, Y. Boliart de San Félix
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Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Universitario Quirón Dexeus, Barcelona, Spain
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