AIM: We report a case of a 64-year-old man, admitted to our department following the onset a few months earlier of canalization disorders and a sensation of retrosternal tension. MATERIAL OF STUDY: Patient's history revealed blunt thoraco-abdominal trauma with multiple costal fractures 15 years earlier as a result of a road accident and a cholecystectomy at the age of 57. A barium meal revealed an intrapericardial displacement of some intestinal loops; as the patient suffered acute intestinal occlusion with severe abdominal pain associated with nausea and vomiting, we performed an emergency median xipho-umbilical laparotomy, making it possible to identify both the site of the retrosternal diaphragmatic laceration with intrapericardial colonic herniation and the true cause of the occlusion: an adhesion, caused by the previous cholecistectomy, which was strangulating a jejuna! loop. After detaching the adhesion between the colon and the pericardium, the viscera were replaced in the abdominal cavity and the diaphragmatic opening was closed. RESULTS: The post-operative period was uneventful; a barium enema demonstrated the abdominal dislocation of the viscera. No recurrence was detected during the 48 months of follow-up. CONCLUSIONS: A rare pathological event, such as an intrapericardial diaphragmatic hernia, was combined with intestinal occlusion, initially attributed to a further complication of the hernia itself but in actual filet independent of the hernia and a consequence of a previous cholecystectomy.

Bini A, Davoli F, Cassanelli N, Dolci G, Luciano G, Stella F. (2010). Unusual delayed presentation of post-traumatic intrapericardial hernia associated with intestinal occlusion. ANNALI ITALIANI DI CHIRURGIA, 8, 45-47.

Unusual delayed presentation of post-traumatic intrapericardial hernia associated with intestinal occlusion.

BINI, ALESSANDRO;DAVOLI, FABIO;CASSANELLI, NICOLA;DOLCI, GIAMPIERO;LUCIANO, GIULIA;STELLA, FRANCO
2010

Abstract

AIM: We report a case of a 64-year-old man, admitted to our department following the onset a few months earlier of canalization disorders and a sensation of retrosternal tension. MATERIAL OF STUDY: Patient's history revealed blunt thoraco-abdominal trauma with multiple costal fractures 15 years earlier as a result of a road accident and a cholecystectomy at the age of 57. A barium meal revealed an intrapericardial displacement of some intestinal loops; as the patient suffered acute intestinal occlusion with severe abdominal pain associated with nausea and vomiting, we performed an emergency median xipho-umbilical laparotomy, making it possible to identify both the site of the retrosternal diaphragmatic laceration with intrapericardial colonic herniation and the true cause of the occlusion: an adhesion, caused by the previous cholecistectomy, which was strangulating a jejuna! loop. After detaching the adhesion between the colon and the pericardium, the viscera were replaced in the abdominal cavity and the diaphragmatic opening was closed. RESULTS: The post-operative period was uneventful; a barium enema demonstrated the abdominal dislocation of the viscera. No recurrence was detected during the 48 months of follow-up. CONCLUSIONS: A rare pathological event, such as an intrapericardial diaphragmatic hernia, was combined with intestinal occlusion, initially attributed to a further complication of the hernia itself but in actual filet independent of the hernia and a consequence of a previous cholecystectomy.
2010
Bini A, Davoli F, Cassanelli N, Dolci G, Luciano G, Stella F. (2010). Unusual delayed presentation of post-traumatic intrapericardial hernia associated with intestinal occlusion. ANNALI ITALIANI DI CHIRURGIA, 8, 45-47.
Bini A; Davoli F; Cassanelli N; Dolci G; Luciano G; Stella F.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/101935
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