A Rare Case of Spontaneous Diaphragmatic Hernia with Gastric Perforation Presenting Like an Empyema
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Abstract
Diaphragmatic hernias are rare and mostly congenital, rarely spontaneous. Perforation and other complications of diaphragmatic hernias are even rarer and associated with significant morbidity and mortality. We report a patient presenting to the emergency department with features of empyema requiring intercostal drainage. However, on clinical worsening, radiological imaging showed features of diaphragmatic hernia and a subsequent thoracostomy revealed a herniated gastric perforation. Such cases are very rare and need a high index of suspicion for the diagnosis and early appropriate surgical management. Otherwise, it is associated with very high rates of mortality.
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[7] Losanoff JE, Edelman DA, Salwen WA, Basson MD. Spontaneous rupture of the diaphragm: case report and comprehensive review of the world literature. J Thorac Cardiovasc Surg 2010; 139(6): e127–e128.
[8] Lim D, Kostin R. The rare and unusual presentation of a gastric perforation in the setting of a large diaphragmatic hernia: a case report and literature review. J Surg Case Rep. 2018; 2018 (9):rjy238.
[9] Vinnicombe Z, Little M, Wan A. An unusual diaphragmatic hernia with gastric perforation and sub-acute presentation. Ann R Coll Surg Engl. 2016; 98(8):e181-e383.
[2] Koh H, Sivarajah S, Anderson D, Wilson C. Incarcerated diaphragmatic hernia as a cause of acute abdomen. J Surg Case Rep. 2012; 2012:4.
[3] Kara E, Kaya Y, Zeybek R, Coskun T, Yavuz C. A case of a diaphragmatic rupture complicated with lacerations of stomach and spleen caused by a violent cough presenting with mediastinal shift. Ann Acad Med Singapore. 2004; 33:649–50.
[4] Caes FL, Francois B, Van Nooten GJ. Transdiaphragmatic herniation of the stomach after right gastroepiploic artery grafting. J Thorac Cardiovasc Surg. 1994; 108(1):191-3.
[5] Pasic M, Carrel T, Von Segesser L, Turina M. Postoperative diaphragmatic hernia after use of the right gastroepiploic artery for coronary artery bypass grafting. J Thorac Cardiovasc Surg. 1994; 108(1):189-91.
[6] Verhofste MA, Tam SK. Diaphragmatic hernia after right gastroepiploic artery coronary artery bypass grafting. Ann Thorac Surg. 1995; 60(2):458-9.
[7] Losanoff JE, Edelman DA, Salwen WA, Basson MD. Spontaneous rupture of the diaphragm: case report and comprehensive review of the world literature. J Thorac Cardiovasc Surg 2010; 139(6): e127–e128.
[8] Lim D, Kostin R. The rare and unusual presentation of a gastric perforation in the setting of a large diaphragmatic hernia: a case report and literature review. J Surg Case Rep. 2018; 2018 (9):rjy238.
[9] Vinnicombe Z, Little M, Wan A. An unusual diaphragmatic hernia with gastric perforation and sub-acute presentation. Ann R Coll Surg Engl. 2016; 98(8):e181-e383.
| Files | ||
| Issue | Vol 10 No 2 (2024): Spring |
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| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/aacc.v10i2.15070 | |
| Keywords | ||
| Diaphragmatic hernia gastric perforation empyema. | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Samprathi A, Pandey N, Arayamparambil P. A Rare Case of Spontaneous Diaphragmatic Hernia with Gastric Perforation Presenting Like an Empyema. Arch Anesth & Crit Care. 2023;10(2):191-193.
