Delayed diagnosis of traumatic diaphragmatic hernia may cause colonic perforation: a case report

Abstract

Early diagnosis of diaphragmatic rupture after traumas may be difficult, and delayed diagnosis may result in increased morbidity and mortality. This paper describes the case of a 32-year-old man who experienced a traffic accident and had diagnosis of traumatic diaphragmatic hernia nearly four months later. The patient was referred to our emergency room suffering from ileus symptoms. Physical examination demonstrated an apparent abdominal distention, tenderness at the upper abdominal quadrants, rebound, and defense. Thoraco-abdominal X-rays and computerized tomography imaging demonstrated intestinal segments with air-fluid levels in thorax. Laparotomy was performed after a preoperative diagnosis of a strangulated-diaphragmatic hernia. At abdominal exploration, it was found that transverse colon and omentum entered into thorax through diaphragmatic defect located at the left diaphragm. Herniating colon segment was complicated with ischemic necrosis and perforation. In conclusion, colon necrosis and perforation may develop when early diagnosis of diaphragmatic ruptures are missed.

Oral and Parenteral Versus Parenteral Antibiotic Prophylaxis in Elective Laparoscopic Colorectal Surgery (JMTO PREV 07–01)

“…4,5 However, the incidence of SSIs in laparoscopic colorectal surgery remains high at around 8% to 23%. [6][7][8] Although several guidelines have been published for antibiotic prophylaxis (ABX) in case of colorectal surgery, [9][10][11] no previous studies have determined the optimal regimen for laparoscopic colorectal surgery. Given that patients undergoing laparoscopic colorectal surgery are allowed to stop intravenous fluids as soon as oral intake becomes possible, we hypothesized that the optimal prophylaxis regimen would be based on the short duration of oral and parenteral administration.…”

Hernia diafragmática complicada con rotura de víscera hueca dentro de la cavidad torácica

“…Alcanzan una mortalidad de hasta un 25%. La presencia de estómago gangrenoso o perforado, y/o intestino delgado en el tórax son los factores más comunes y agravantes 8,9 . La mayoría de las hernias diafragmáticas son asintomáticas y son hallazgos incidentales en imáge-nes realizadas por otras causas.…”

Late Complication In Patient With Traumatic Diaphragmatic Defect: Internal Hernia

“…Diyafragma rüptürünün oluşması için büyük bir gerektiğinden dolayı bu hastalar genellikle çoğul organ hasarlıdır (2). Diyafragma rüptürleri, penetran veya künt torakoabdominal travmaların %0, 6'sı ve tüm vücut travmalarının %4,5-6'sında görülmektedir (3,4). Tanısının zor olması nedeni ile akut dönemde hastaların gözden kaçırılması kolay olabilmektedir (5).…”

“…Tanısının zor olması nedeni ile akut dönemde hastaların gözden kaçırılması kolay olabilmektedir (5). Bu hastaların tanı konma süreleri birkaç günden birkaç yıla kadar uzayabilir (6). Gecikmiş tanı ve tedavi, mortalite ve morbiditede artışı ile sonuçlanır (3).…”

“…Gecikmiş tanı ve tedavi, mortalite ve morbiditede artışı ile sonuçlanır (3). Erken tanı konulamaz ve tedavi erken dönemde yapılmaz ise; toraks içerisine fıtıklaşmış organlarda tıkanma ve/veya strangülasyon meydana gelebilir (6).…”