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Pneumothorax means the presence of air in the pleural space — the thin potential gap between the visceral and parietal pleura. This condition disrupts the normal pressure balance that keeps the lungs inflated, leading to partial or complete collapse of the affected lung.Normal physiologyUnder normal conditions, the pleural space maintains a slightly negative intrapleural pressure, which keeps the lungs expanded against the chest wall. This negative pressure creates a delicate balance between...

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Locked lung by looped hernia: a case report.

Abu-Ahmed Z Rahman¹, Mukta Panda

¹Department of Internal Medicine; UTCOM, Chattanooga, 960 East Third Street Suite 200, White Hall Building, Chattanooga, TN 37403, USA. abu.z.rahman@gmail.com.

|January 10, 2009

Summary

A rare case of asymptomatic massive pleural effusion and lung collapse was caused by a traumatic diaphragmatic hernia. Surgical repair resolved the effusion, highlighting this unusual presentation of diaphragmatic hernia.

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Area of Science:

Thoracic Surgery
Gastroenterology
Pulmonology

Background:

Large pleural effusions typically cause symptoms.
Massive, asymptomatic left-sided pleural effusion with lung collapse is uncommon.
Traumatic diaphragmatic hernias can present insidiously.

Purpose of the Study:

To report a unique case of asymptomatic massive pleural effusion.
To highlight the diagnostic challenge of diaphragmatic hernia presenting as pleural effusion.
To emphasize the importance of considering diaphragmatic hernia in undiagnosed effusions.

Main Methods:

A 44-year-old male with recurrent pleural effusions was evaluated.
Diagnostic studies were performed to determine the effusion's cause.
Video-assisted thoracoscopy was used for diagnosis and treatment.

Main Results:

The patient presented with a six-week history of recurrent pleural effusions.
Initial diagnostic workup for the effusion was inconclusive.
Video-assisted thoracoscopy identified an incarcerated diaphragmatic hernia with omentum.
Following hernia repair, pleural effusion recurrence ceased.

Conclusions:

Incarcerated diaphragmatic hernia can present as massive, recurrent pleural effusions.
This case emphasizes the need to consider diaphragmatic hernia in unexplained pleural effusions.
Prompt surgical intervention is crucial for resolution and preventing recurrence.