Caitlin T Yeo* and Wiley Chung
Department of Surgery, Queen’s University, Kingston, CanadaFulltext PDF
We present a patient who was admitted with hypoxemia and was thought to have a right-sided empyema secondary to a parapneumonic effusion. She was treated for two weeks prior to being transferred for a Thoracic Surgery consultation. On review of imaging she actually had a right diaphragmatic hernia with strangulated, perforated small bowel. She was initially stable but during transfer developed increasing respiratory requirements requiring emergent surgery. Atraumatic adult right-sided incarcerated diaphragmatic hernia with bowel perforation is extremely rare with only two other cases reports involving colon and none involving small bowel. We describe her presentation, management, and post-operative considerations.
Diaphragmatic hernia; Perforated small bowel
Yeo CT, Chung W. A Missed Case of a Strangulated Right-Sided Diaphragmatic Hernia Containing Perforated Small Bowelin an Elderly Patient. Clin Surg. 2018; 3: 1858.