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International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
Published on: March 12, 2020
Tension hemothorax following abdominal surgery - a rare presentation of congenital diaphragmatic defect
C K Choong1, G N Coulter, F A Frizelle
1Department of Surgery, Christchurch Hospital, Riccarton Ave, Christchurch, New Zealand.
Background:
Small congenital diaphragmatic defects are usually occult, but can present as a problem in patients with increased abdominal fluid as unilateral massive hydrothorax. We present a unique case presentation of a small congenital diaphragmatic defect.
Case Report:
A 79 female immediately postoperatively developed a hydrothorax following low anterior resection for rectal cancer. The hydrothorax turned out to be due to an intrabdominal bleed in a patient with a previously undiagnosed congenital diaphragmatic hernia. The respiratory ball value mechanism worked as a pump to move blood from the abdomen to the chest and caused a tension hemothorax.
Results:
Surgeons should be aware that a post operative hydrothorax could be associated with an intrabdominal complication of recent surgery.
Conclusions:
A small occult congenital diaphragmatic defect and associated ball value mechanism may provide an unexpected but clinically significant communication between the abdominal and thoracic cavities.
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