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[Fecothorax, gangrene and the diaphragm loss--a case review]

J Hoch1, M Pelichovská, V Janík

  • 1Chirurgická klinika, 2. LF UK a FN Motol, Praha. jiri.hoch@lfmotolcuni.cz

Rozhledy V Chirurgii : Mesicnik Ceskoslovenske Chirurgicke Spolecnosti
|September 18, 2004
PubMed

Insights

This case report details a rare simultaneous occurrence of stercoral peritonitis and pyothorax, complicated by diaphragmatic gangrene. Despite extensive surgical intervention and intensive therapy, the patient survived and healed from these life-threatening conditions.

Area of Science:

  • Gastroenterology and Thoracic Surgery
  • Surgical Case Reports
  • Critical Care Medicine

Background:

  • Stercoral peritonitis and pyothorax are rare but severe conditions.
  • Simultaneous presentation with diaphragmatic gangrene is exceptionally uncommon.
  • This case involves a patient with sigmoid diverticular perforation leading to diffuse peritonitis.

Observation:

  • The patient presented with concurrent stercoral peritonitis and pyothorax.
  • A gangrenous and perforated diaphragm was observed.
  • Initial surgery involved repair of the peritoneal and pleural cavities, with mesh placement for the diaphragm.

Findings:

  • The patient required mesh explantation due to late intraabdominal complications.
  • Despite multiple surgeries and intensive care, the patient achieved survival and healing.
  • The left lung remained functional due to visceral displacement and adhesions, compensating for the missing diaphragm.

Implications:

  • This case highlights the possibility of managing extremely rare and complex surgical emergencies.
  • Successful outcomes are achievable with aggressive surgical management and prolonged intensive care.
  • The natural healing process, including visceral dislocation and adhesions, played a crucial role in maintaining lung function.

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