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Intrathoracic caecal perforation presenting as dyspnea.

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Granier, Vincent Coche, Emmanuel [UCL] Hantson, Philippe [UCL] Thoma, Maximilien [UCL]

Introduction. Bochdalek hernia is a congenital defect of the diaphragm that is usually diagnosed in the neonatal period and incidentally in asymptomatic adults. Small bowel incarceration in a right-sided Bochdalek hernia is exceptional for an adult. Case Presentation. A 54-year-old woman was admitted for acute dyspnea, tachycardia, hypotension, and fever. Five days before, she had been experiencing an episode of diffuse abdominal pain. The admission chest X-ray was interpreted as right pleural effusion and pneumothorax with left mediastinal shift. Chest tube drainage was purulent. The thoracoabdominal CT examination suspected an intestinal incarceration through a right diaphragmatic defect. At laparotomy, a right-sided Bochdalek hernia was confirmed with a complete necrosis of the incarcerated caecum. Ileocaecal resection was performed, but the patient died from delayed septic complications. Conclusion. Intrathoracic perforation of the caecum is a rare occurrence; delayed diagnosis due to misleading initial symptoms may lead to severe complications and poor prognosis.

Document type Article de périodique (Journal article) – Journal Article
Access type Accès restreint
Publication date 2010
Language Anglais
Journal information "Case reports in medicine" - Vol. 2010, p. 296730 (2010)
Peer reviewed yes
Publisher Hindawi Pub. Corp. ((United States) New York, NY)
issn 1687-9627
Publication status Publié
Affiliations UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale
UCL - SSS/IREC/MEDA - Pôle de médecine aiguë
UCL - (SLuc) Service de radiologie
UCL - (SLuc) Service de soins intensifs
Links
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Bibliographic reference Granier, Vincent ; Coche, Emmanuel ; Hantson, Philippe ; Thoma, Maximilien. Intrathoracic caecal perforation presenting as dyspnea.. In: Case reports in medicine, Vol. 2010, p. 296730 (2010)
Permanent URL http://hdl.handle.net/2078.1/88983