Large bowel obstruction complicating a posttraumatic diaphragmatic hernia.
- Author:
Umer Hasan BHATTI
1
;
Surrendar DAWANI
Author Information
1. Department of Surgery Ward 21, Jinnah Postgraduate Medical Centre, Karachi, Pakistan 75510. uhbhatti88@gmail.com.
- Publication Type:Case Reports
- MeSH:
Adult;
Colon, Transverse;
Colonic Diseases;
diagnosis;
etiology;
Diagnosis, Differential;
Hernia, Diaphragmatic, Traumatic;
complications;
diagnosis;
Humans;
Intestinal Obstruction;
diagnosis;
etiology;
Male;
Tomography, X-Ray Computed
- From:Singapore medical journal
2015;56(4):e56-8
- CountrySingapore
- Language:English
-
Abstract:
Posttraumatic diaphragmatic hernia is a rare cause of large bowel obstruction, and can present weeks or years after the initial trauma. Herein, we report the case of a 28-year-old man who presented with signs and symptoms of bowel obstruction nine months after he had a stab wound to his left chest. Chest radiography showed multiple air‑fluid levels in the right upper quadrant, an air-fluid level in the left thoracic cavity and significant free air under the diaphragm. Exploratory laparotomy revealed a contaminated abdomen with perforations in the caecum and proximal transverse colon, and a 4 cm × 4 cm defect in the left posterolateral (septal) aspect of the diaphragm, which was closed with a nonabsorbable suture. Posttraumatic diaphragmatic hernias should be part of the differential diagnosis for patients with bowel obstruction, especially if there is a history of trauma. Radiography is useful in facilitating a quick diagnosis.
