Case report of a 72-year-old man with diaphragmatic hernia and thoracic gastropericardial fistula after esophagectomy for 18 years

Abstract Background Both diaphragmatic hernia and thoracic gastropericardial fistula rarely occur simultaneously in patients with radical esophagectomy. Case presentation A 72-year-old man presented to our hospital with 1 day of nausea, vomiting and acute left chest pain. He had radical esophagectomy (Sweet approach) for esophageal cancer 18 years ago. Computed tomography (CT) of the chest revealed diaphragmatic hernias and air collection within the pericardial space. While an operation of diaphragmatic hernia repair was decisively performed to prevent further serious complications, unusually, a thoracic gastropericardial fistula was also found unusually. Conclusion Diaphragmatic hernia and thoracic gastropericardial fistula may occasionally coexist in patients with esophagectomy. Upper GI radiograph with a water-soluble contrast agent is a better diagnostic tool than CT in visualizing the fistula.

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Case report of A 72-year-old Man with Diaphragmatic Hernias and Thoracic Gastropericardial Fistula after Esophagectomy for 18 Years

10.21203/rs.3.rs-431864/v1 ◽

2021 ◽

Author(s):

Xinjian Xu ◽

Zhaoyang Yan ◽

Ming He

Keyword(s):

Water Soluble ◽

Radical Esophagectomy ◽

Case Presentation ◽

Left Chest ◽

Upper Gi ◽

Gastropericardial Fistula ◽

Water Soluble Contrast ◽

Diagnosis Tool ◽

Diaphragmatic Hernias ◽

Diaphragmatic Hernia Repair

Abstract Background: Both diaphragmatic hernias and thoracic gastropericardial fistula rarely occurred simultaneously on patients with radical esophagectomy.Case presentation: A 72-year-old man presented to our hospital with one day of nausea, vomiting and acute left chest pain. He had radical esophagectomy for esophageal cancer 18 years ago. Computed tomography (CT) of the chest revealed diaphragmatic hernias and air collection within pericardial space. While an operation of diaphragmatic hernia repair was decisively performed to prevent further serious complications, the thoracic gastropericardial fistula was also found unusually. Conclusion: Diaphragmatic hernias and thoracic gastropericardial fistula may occasionally coexist in patients with esophagectomy. Upper GI radiograph with water-soluble contrast agent is a better diagnosis tool than CT in visualizing the fistula.

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Faecopneumothorax due to missing diaphragmatic hernia: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-020-02606-3 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Resul Nusretoğlu ◽

Yunus Dönder

Keyword(s):

Computed Tomography ◽

Diaphragmatic Hernia ◽

Colon Resection ◽

Emergency Laparotomy ◽

Hernia Sac ◽

Case Presentation ◽

Abdominal Tenderness ◽

History Of ◽

Diaphragmatic Hernias ◽

Tomography Scan

Abstract Background Diaphragmatic hernias may occur as either congenital or acquired. The most important cause of acquired diaphragmatic hernias is trauma, and the trauma can be due to blunt or penetrating injury. Diaphragmatic hernia may rarely be seen after thoracoabdominal trauma. Case presentation A 54-year-old Turkish male patient admitted to the emergency department with abdominal pain and dyspnea ongoing for 2 days. He had general abdominal tenderness in all quadrants. He had a history of a stabbing incident in his left subcostal region 3 months ago without any pathological findings in thoracoabdominal computed tomography scan. New thoracoabdominal computed tomography showed a diaphragmatic hernia and fluid in the hernia sac. Due to respiratory distress and general abdominal tenderness, the decision to perform an emergency laparotomy was made. There was a 6 cm defect in the diaphragm. There were also necrotic fluids and stool in the hernia sac in the thorax colon resection, and an anastomosis was performed. The defect in the diaphragm was sutured. The oral regimen was started, and when it was tolerated, the regimen was gradually increased. The patient was discharged on the postoperative 11th day. Conclusions Acquired diaphragmatic hernia may be asymptomatic or may present with complications leading to sepsis. In this report, acquired diaphragmatic hernia and associated colonic perforation of a patient with a history of stab wounds was presented.

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An Atypical Presentation of a Strangulated Bochdalek Hernia in a 60-Year-Old Man

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.465 ◽

2019 ◽

Vol 7 (11) ◽

pp. 1818-1820

Author(s):

Danilo Coco ◽

Silvana Leanza

Keyword(s):

Abdominal Pain ◽

Congenital Diaphragmatic Hernia ◽

Male Patient ◽

Diaphragmatic Hernia ◽

Laparoscopic Approach ◽

Atypical Presentation ◽

Bochdalek Hernia ◽

Case Presentation ◽

Diaphragmatic Hernias

BACKGROUND: Bochdalek hernia is a type of congenital diaphragmatic hernia (CDH), which more commonly affects children. Congenital left diaphragmatic hernias, such as Bochdalek, rarely occur in adults. Most such cases do not present any symptoms. CASE PRESENTATION: Here, we report the case of a 60-year-old male with a left-sided Bochdalek diaphragmatic hernia, who presented with abdominal pain and dyspnea. The patient was successfully treated by laparoscopic approach.CONCLUSION: The 60-year-old male patient had left-sided BH and was successfully cured by the laparoscopic approach.

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Right-sided strangulating diaphragmatic hernia in an adult without history of trauma: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02861-y ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Konstantinos G. Spiridakis ◽

Mathaios E. Flamourakis ◽

Ioannis G. Gkionis ◽

Eleni I. Kaloeidi ◽

Anthoula I. Fachouridi ◽

...

Keyword(s):

Diaphragmatic Hernia ◽

Clinical Status ◽

Traumatic Injury ◽

Postoperative Recovery ◽

Case Presentation ◽

Uneventful Postoperative Recovery ◽

History Of ◽

Chest X Ray ◽

The Right ◽

Diaphragmatic Hernias

Abstract Background Diaphragmatic hernia involves protrusion of abdominal contents into the thorax through a defect in the diaphragm. This defect can be caused either by developmental failure of the posterolateral foramina to fuse properly, or by traumatic injury of the diaphragm. Left-sided diaphragmatic hernias are more common (80–90%) because the right pleuroperitoneal canal closes earlier and the liver protects the right diaphragm. Diaphragmatic hernias in adults are relatively asymptomatic, but in some cases may lead to incarcerated bowel, intraabdominal organ dysfunction, or severe pulmonary disease. The aim of this report is to enlighten clinical doctors about this rare entity that can have fatal consequences for the patient. Case presentation We present a rare case of a right-sided strangulating diaphragmatic hernia in an adult Caucasian patient without history of trauma. Clinical examination revealed bowel sounds in the right hemithorax, which were confirmed by the presence of loops of small intestine into the right part of the thorax through the right diaphragm, as was shown on chest X-ray and computerized tomography. Deterioration of the clinical status of the patient led to an operation, which revealed strangulated necrotic small bowel. Approximately 1 m of bowel was removed, and laterolateral anastomosis was performed. The patient had an uneventful postoperative recovery and was discharged 8 days later. Conclusions Surgery is required to replace emerged organs into the abdomen and to repair diaphragmatic lesion. A delayed approach can have catastrophic complications for a patient.

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Faecopneumothorax revealing a neglected traumatic diaphragmatic hernia

Journal of Lung Pulmonary & Respiratory Research ◽

10.15406/jlprr.2019.06.00201 ◽

2019 ◽

Vol 6 (2) ◽

pp. 26-27

Author(s):

B Chaoui ◽

I Nassar ◽

N MoatassimBillah

Keyword(s):

Diaphragmatic Hernia ◽

Rare Complication ◽

Case Presentation ◽

Traumatic Diaphragmatic Hernia ◽

Latent Stage ◽

Left Hypochondrium ◽

Life Threatening ◽

Therapeutic Attitude ◽

Post Traumatic ◽

Diaphragmatic Hernias

Introduction: Tension fecopneumothoraxis a rare but serious complication of traumatic diaphragmatic hernias. The diagnosis of the hernia can be delayed from a few days to some years and will be made on occasion of complications representing the dramatic evolution of the “latent stage” of disease. Only few cases of post-traumatic faecopneumothorax are described in the literature. This clinical evolution is associated to a significant increase in morbidity (30–80% of cases). This is particularly the case with our patient. Case presentation: We report the case of a 26-year-old who had a trauma of the left hypochondrium about a year ago and who presented an acute intestinal occlusion, an X ray abdomen and chest was performed, showing abundant hydropneumothorax, thethoracoabdominal scan reveals an abundant effusion with heterogeneous density in the left pleural cavity, associated with an intrapleural hernia of the large intestine Discussion: Tension fecopneumothorax is a very rare complication of traumatic diaphragmatic hernia, only few cases are described in the literature, the mechanisms of the injury can blunt or penetrating, it occurs after intrapleural perforation of a strangulated colon, and very often its life threatening. Conclusion: According to our knowledge and review of the literature, Tension fecopneumothorax complicating a traumatic diaphragmatic hernia is very rare; the diagnosis is made by thoracic radiography and thoracoabdominalCT, which also allow orientation of the therapeutic attitude with non-negligible post-operative complications.

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Tension Viscerothorax in a Patient with Missed Traumatic Diaphragmatic Hernia. A Case Report.

European Journal of Medical and Health Sciences ◽

10.24018/ejmed.2020.2.2.181 ◽

2020 ◽

Vol 2 (2) ◽

Author(s):

Herbert Butana ◽

Ntawunga Laurance ◽

Desire Rubanguka ◽

Isaie Sibomana

Keyword(s):

Emergency Department ◽

Case Report ◽

Diaphragmatic Hernia ◽

Rare Case ◽

Case Presentation ◽

X Ray ◽

Traumatic Diaphragmatic Hernia ◽

Provincial Hospital ◽

Chest X Ray ◽

Diaphragmatic Hernias

Background: Diaphragmatic hernias occurring post trauma are a challenge to diagnose early especially when they follow blunt trauma. Many of those diagnosed early occur in penetrating thoraco-abdominal trauma which necessitates emergency exploration where the diagnosis is picked. Rarity of traumatic diaphragmatic hernia coupled with poor sensitivity of easily available imaging modalities makes it a big challenge to pick up this potentially fatal pathology. Case presentation: We present a rare case of tension viscerothorax in a young man who had presented to the emergency department at a provincial hospital of Rwanda three days before the second consultation where the chest x-ray was interpreted as normal and later as a pneumothorax before the diagnosis and treatment of tension viscerothorax could be made. Conclusion: Viscerothorax is an elusive diagnosis which when missed can complicate to strangulation of hernia contents or tension viscerothorax which carry a high mortality.

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