J Med Case Rep

. 2021 Jan 23;15(1):19. doi: 10.1186/s13256-020-02606-3. https://pubmed.ncbi.nlm.nih.gov/33482880/

Faecopneumothorax due to missing diaphragmatic hernia: a case report

Resul Nusretoğlu ¹, Yunus Dönder ²Affiliations expand

• PMID: 33482880
• PMCID: PMC7825218
• DOI: 10.1186/s13256-020-02606-3

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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.

Keywords: Diaphragmatic injury; Diaphragmatic trauma; Faecopneumothorax; Penetrating trauma; Traumatic diaphragmatic hernia.