Perforated Gastric Gangrene without Pneumothorax in an Adult Bochdalek Hernia due to Volvulus

Autor: Manipadam Jm, Ambady, Sebastian Gm, Hariharan R
Rok vydání: 2016
Předmět:
Zdroj: Journal of Clinical and Diagnostic Research, Vol 10, Iss 4, Pp PD09-PD10 (2016)
ISSN: 2249-782X
DOI: 10.7860/jcdr/2016/18032.7552
Popis: Bochdalek hernia is the most frequent congenital diaphragmatic hernia which occurs due to a defect in the posterior attachment of the diaphragm when there is a failure of closure of the pleuroperitoneal membrane in utero. It rarely presents for the first time in adults. We report one such case of a 23-year-old male patient who presented with an acute abdomen. Chest X-ray showed air under diaphragm and he was taken up for an emergency laparotomy. Intraoperatively an organoaxial volvulus of the stomach was found in a bochdaleks hernia with a focal gangrene of the stomach fundus with perforation and peritonitis. However, there was no breach of pleural cavity. A sleeve resection of the gangrenous portion of the stomach was performed and the diaphragmatic defect was repaired. Patient made an uneventful postoperative recovery. Gastric gangrene with perforation as a manifestation of the adult bochdalek hernia is indeed rare. A concomitant pneumothorax occurs along with this condition which requires an intercostal drainage tube prior to the laparotomy. We report this case for its unique presentation without pneumothorax.
Databáze: OpenAIRE