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Incarcerated diaphragmatic hernia as a cause of acute abdomen

H Koh1, S Sivarajah1, D Anderson1

  • 1Victoria Infrimary, Glasgow, UK.

Journal of Surgical Case Reports
|June 25, 2014
PubMed

Insights

Congenital diaphragmatic hernias are rare in adults but can cause serious complications. This case highlights a rare adult presentation with bowel obstruction and perforation, requiring complex surgical intervention and recovery.

Area of Science:

  • Medicine
  • Surgery
  • Gastroenterology

Background:

  • Congenital diaphragmatic hernias (CDH) are typically diagnosed in neonates.
  • Adult CDH presentations are rare, often presenting with nonspecific symptoms.

Purpose of the Study:

  • To report a rare case of complicated adult congenital diaphragmatic hernia.
  • To discuss the diagnostic challenges and management of adult CDH.

Main Methods:

  • Case presentation of an adult male with atypical abdominal pain and respiratory distress.
  • Radiological investigations (imaging) to identify left hydropneumothorax and bowel obstruction.
  • Surgical intervention including laparotomy, hemicolectomy, ileostomy, and thoracostomy tube insertion.

Main Results:

  • Confirmed herniation of omentum and transverse colon through a left congenital diaphragmatic defect.
  • Diagnosis of perforated transverse colon and left hydropneumothorax.
  • Postoperative complications included empyema, managed with thoracotomy and decortication.

Conclusions:

  • Adult congenital diaphragmatic hernia can present with severe gastrointestinal and respiratory complications.
  • Prompt diagnosis and aggressive surgical management are crucial for favorable outcomes.
  • Multidisciplinary care is essential for managing complex postoperative complications like empyema.

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