Post-traumatic Diaphragmatic Hernia Revealed by a Tension Fecopneumothorax (A Case Report)

Abstract

The occurrence of a traumatic diaphragmatic hernia is a classic complication of abdominal trauma. Unknown in almost half of the cases during the initial trauma, the diagnosis was made at the time of a complication. The left diaphragmaticdome is the most frequently affected. Tension fecopneumothorax following diaphragmatichernia perforation in the pleural cavityisa rare but particularly aserious complication. A 29-year-old man was admitted for acute intestinal obstruction with respiratory distress. A history of a violent thoraco-abdominal traumatism due to a stabbing injury on the left hemithorax six years before was noted. The chest X-ray showed a medium abundance hydropneumothorax and the thoraco-abdominals can revealed medium abundance effusion in the left hemithorax, with a small intestinehernia and the omentum intrapleural. An emergency laparotomy discovered tension feco pneumothorax secondary to intrathoracic perforation of the small intestine through a left hemidiaphragmd efect. The surgical treatment consisted of reducingthe hernia, pleural drainage, ileostomy and fixing the diaphragmaticd efect. The possibility of diaphragmatic hernia should be kept in mind in case of violent blunt thoraco-abdominal traumatism or basi thoracic wound. In this way, complications such as tension fecopneumothorax that could threaten the functional and vital prognosis may be prevented.