Non-traumatic left-sided diaphragmatic hernia causing volvulus in an adult

Diaphragmatic hernias can be classified into congenital and acquired types. Most cases of congenital diaphragmatic hernia present early in life with respiratory distress while acquired diaphragmatic hernia usually presents following a history of trauma. Adult presentation of congenital diaphragmatic...

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Main Author: Ahmed T. Abdelhamid, MBChB
Format: Article
Language:English
Published: Elsevier 2023-03-01
Series:Radiology Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1930043322009840
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author Ahmed T. Abdelhamid, MBChB
author_facet Ahmed T. Abdelhamid, MBChB
author_sort Ahmed T. Abdelhamid, MBChB
collection DOAJ
description Diaphragmatic hernias can be classified into congenital and acquired types. Most cases of congenital diaphragmatic hernia present early in life with respiratory distress while acquired diaphragmatic hernia usually presents following a history of trauma. Adult presentation of congenital diaphragmatic hernia is a rare finding and can remain asymptomatic for years until the herniated abdominal contents cause significant respiratory or gastrointestinal complications. This is a case report of a 55-year-old male patient presented to the emergency department with acute left-sided chest pain associated with dyspnea and abdominal distension. Chest roentgenogram showed gastric air bubble in the chest cavity. After initial resuscitation, CT thorax, abdomen, and pelvis was done which showed large diaphragmatic hernia with a wide central defect in the diaphragm with entire stomach and distal pancreas along with fat and omentum have been herniated into the thorax with organo-axial rotation of the stomach denoting volvulus and some degree of obstruction. Resultant marked distension of the stomach with air-fluid levels noted. Diagnosis of congenital diaphragmatic hernia can be challenging. Physical examination including auscultation of bowel sounds in the chest offers a diagnostic clue but the mainstay of diagnosis by chest imaging including chest roentgenogram and CT scan of the thorax and abdomen.
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spelling doaj.art-4ee0d3ac4fdd467a818b54f10a0776e82023-01-29T04:19:46ZengElsevierRadiology Case Reports1930-04332023-03-01183899902Non-traumatic left-sided diaphragmatic hernia causing volvulus in an adultAhmed T. Abdelhamid, MBChB0St. Helens and Knowsley NHS Foundation, Prescot, UKDiaphragmatic hernias can be classified into congenital and acquired types. Most cases of congenital diaphragmatic hernia present early in life with respiratory distress while acquired diaphragmatic hernia usually presents following a history of trauma. Adult presentation of congenital diaphragmatic hernia is a rare finding and can remain asymptomatic for years until the herniated abdominal contents cause significant respiratory or gastrointestinal complications. This is a case report of a 55-year-old male patient presented to the emergency department with acute left-sided chest pain associated with dyspnea and abdominal distension. Chest roentgenogram showed gastric air bubble in the chest cavity. After initial resuscitation, CT thorax, abdomen, and pelvis was done which showed large diaphragmatic hernia with a wide central defect in the diaphragm with entire stomach and distal pancreas along with fat and omentum have been herniated into the thorax with organo-axial rotation of the stomach denoting volvulus and some degree of obstruction. Resultant marked distension of the stomach with air-fluid levels noted. Diagnosis of congenital diaphragmatic hernia can be challenging. Physical examination including auscultation of bowel sounds in the chest offers a diagnostic clue but the mainstay of diagnosis by chest imaging including chest roentgenogram and CT scan of the thorax and abdomen.http://www.sciencedirect.com/science/article/pii/S1930043322009840Diaphragmatic herniaDiaphragmatic defectObstructionVolvulus
spellingShingle Ahmed T. Abdelhamid, MBChB
Non-traumatic left-sided diaphragmatic hernia causing volvulus in an adult
Radiology Case Reports
Diaphragmatic hernia
Diaphragmatic defect
Obstruction
Volvulus
title Non-traumatic left-sided diaphragmatic hernia causing volvulus in an adult
title_full Non-traumatic left-sided diaphragmatic hernia causing volvulus in an adult
title_fullStr Non-traumatic left-sided diaphragmatic hernia causing volvulus in an adult
title_full_unstemmed Non-traumatic left-sided diaphragmatic hernia causing volvulus in an adult
title_short Non-traumatic left-sided diaphragmatic hernia causing volvulus in an adult
title_sort non traumatic left sided diaphragmatic hernia causing volvulus in an adult
topic Diaphragmatic hernia
Diaphragmatic defect
Obstruction
Volvulus
url http://www.sciencedirect.com/science/article/pii/S1930043322009840
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