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Colon in the chest: an incidental dextrocardia: a case report study
Abd Elrazek Abd Elrazek1, Abdullah Shehab, Asim A Elnour
1From the Division of Liver Transplantation and Liver Research, Gastroenterology and Hepatology Department (AEAE), Faculty of Medicine, Al-Azhar University, Egypt; Cardiovascular Medicine Department (AS); Pharmacology Department (AAE), Faculty of Medicine and Health Sciences; Department of internal medicine (SKAN), United Arab Emirates University, United Arab Emirates; and Chest and ICU Department (SB), Faculty of Medicine, Aswan University, Egypt.
A rare nontraumatic diaphragmatic hernia caused acquired dextrocardia in an elderly woman. Surgical repair was performed, but the patient experienced sudden cardiac arrest postoperatively.
Area of Science:
- Cardiology
- Gastroenterology
- Thoracic Surgery
Background:
- Diaphragmatic injuries are uncommon, often subtle, and can be missed by imaging.
- Nontraumatic diaphragmatic hernias may present without obvious symptoms, complicating diagnosis.
Observation:
- A 75-year-old woman with constipation presented with shortness of breath, cough, tachycardia, and chest pain.
- Incidental dextrocardia was diagnosed, revealing a left diaphragmatic hernia with abdominal viscera in the thorax.
- Gastrointestinal contents displaced the heart, causing acquired dextrocardia.
Findings:
- Laparoscopic surgical repair using a polyethylene mesh successfully closed the diaphragmatic defect.
- The patient initially recovered well but experienced sudden, unexplained cardiac arrest 5 days postoperatively.
Implications:
- Intrathoracic herniation of abdominal viscera should be considered in patients with chest pain and increased intra-abdominal pressure.
- This case highlights the potential for subtle diaphragmatic injuries to cause significant cardiac displacement and complications.
