[Hepatic cholestasis resulting from a long-standing enterothorax: a case report]
P Ambe1, D Häussinger, V Schneitler
1Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
Zeitschrift Fur Gastroenterologie
|March 15, 2013
Summary
An enterothorax, a condition where abdominal organs enter the chest cavity through a diaphragmatic defect, often goes undetected. Surgical repair is recommended even for asymptomatic cases to prevent serious complications like bile duct compression and liver issues.
Area of Science:
- Gastroenterology
- Thoracic Surgery
- Abdominal Surgery
Background:
- Enterothorax, resulting from diaphragmatic defects, frequently remains asymptomatic and undetected in adults.
- Symptomatic presentations typically involve bowel obstruction, necessitating surgical repair of the diaphragmatic defect, often with mesh augmentation.
Observation:
- A 72-year-old female with a history of "upside-down stomach" presented with painless jaundice and signs of liver cirrhosis.
- Preoperative imaging revealed an enterothorax compressing the common bile duct.
Findings:
- Exploratory laparotomy confirmed liver cirrhosis with intrahepatic cholestasis, a hydropic gallbladder, and a right-sided diaphragmatic defect with enterothorax.
- Surgical intervention included intestinal repositioning, cholecystectomy, bile duct revision, and mesh repair of the diaphragmatic defect.
Implications:
- Diaphragmatic defects are a primary cause of enterothorax, which can lead to complex clinical scenarios.
- Proactive surgical repair of diaphragmatic defects, even when incidentally discovered in asymptomatic individuals, is crucial to avert severe complications.
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