Large-Bowel Obstruction as a Late Sequela of Retrosternal Diaphragmatic Hernia

 

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Zusammenfassung

Ein 37-jähriger Mann, der vor 16 Jahren aus der Höhe gestürzt war, präsentierte sich mit einem akuten Abdomen. Bei der Untersuchung wurde eine intestinale Obstruktion festgestellt, die durch eine Zwerchfellhernie verursacht worden war. Der Patient hatte infolge der linken Zwerchfellhernie ein inkarzeriertes Omentum und eine Richter-Hernie des Querkolons und infolgedessen einen Dickdarmileus. Nach Resektion des strangulierten Omentums und Rückverlagerung des Dickdarms in das Abdomen wurde die Hernie über einen abdominal-transthorakalen Zugang chirurgisch korrigiert. Das Auftreten eines Ileus als relativ seltene Spätfolge eines linksseitigen Enterothorax macht diesen Fall beachtenswert und unterstreicht die Notwendigkeit einer frühzeitigen Operation, um Spätkomplikationen zu vermeiden.

Abstract

A 37-year-old man with a past history of a fall from height 16 years previously was admitted with acute abdomen. Investigations revealed intestinal obstruction caused by a diaphragmatic hernia. He had an incarcerated omentum and Richter’s hernia of the transverse colon secondary to left diaphragmatic hernia leading to colonic ileus. Following resection of the strangulated omentum and reduction of the colon intraabdominally, a surgical repair of the hernia was performed using an abdominal and transthoracic approach. The relatively rare late complication of a left-sided enterothorax with ileus makes this a remarkable case and underlines the need for early surgery to avoid late complications.

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Adnan Taş, MD

Erzurum mahallesi dumlup?nar caddesi eceabant sokak ethembey apartman? 14/4

Cebeci

Çankaya

Ankara

Turkey

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Email: dradnantas@gmail.com