[A late post-traumatic diaphragmatic hernia revealed by a tension fecopneumothorax (a case report)].

Abstract:

INTRODUCTION:Post-traumatic diaphragmatic hernia is a particular lesion in traumatology that may be neglected. Thus, the diagnosis may be delayed for a few days to several months and only be made following a complication. The left diaphragmatic cupola is the most touched. Tension fecopneumothorax following diaphragmatic hernia perforation in the pleural cavity is a rare but particularly severe complication of traumatic diaphragmatic hernia. CASE REPORT:A 68-year-old man was admitted for acute intestinal occlusion with respiratory distress. A history of a violent blunt thoraco-abdominal traumatism resulting from a traffic accident eight years before was noted. The chest x-ray revealed an abundant hydropneumothorax and the thoracic scan revealed abundant effusion with heterogeneous density in the left pleural cavity, associated with an intrapleural hernia of the large intestine. An emergency thoracolaparotomy discovered tension fecopneumothorax secondary to intrathoracic perforation of the transverse colon through a left hemidiaphragm defect. The surgical treatment consisted of hernia reduction, pleural drainage, colostomy and repair of the diaphragmatic defect. CONCLUSION:The possibility of diaphragmatic hernia should be kept in mind in case of violent blunt thoraco-abdominal traumatism or basithoracic wound. In this way, complications such as tension fecopneumothorax that could threaten the functional and vital prognosis may be prevented.

journal_name

Rev Pneumol Clin

authors

Kafih M,Boufettal R

doi

10.1016/j.pneumo.2008.10.004

subject

Has Abstract

pub_date

2009-02-01 00:00:00

pages

23-6

issue

1

eissn

0761-8417

issn

1776-2561

pii

S0761-8417(08)00165-X

journal_volume

65

pub_type

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