Southeast Asian Journal of Case Report and Review
Official Publication of Association of Biomedical Scientists
Official Publication of Association of Biomedical Scientists
Online ISSN: 2319-1090
Southeast Asian Journal of Case Report and Review is a Peer-reviewed, International medical journal Published by the Association of Health Professionals. It will publish 04 issues per year will publish a research paper prepared by Health Professional. Journal will Give Preference to Case Report and Review Article Aim and Scope The aim and commitment of the journal is to publish a research-oriented manuscript on significant issues in all the subjects and areas of Medical Science including Genome mutation and Pathogenicity in microbes. Journal more...Case Report
Author Details :
Volume : 11, Issue : 1, Year : 2024
Article Page : 1-5
https://doi.org/10.18231/j.sajcrr.2024.001
Abstract
Background: Traumatic diaphragmatic hernia is an uncommon sequela of blunt and penetrating trauma. It is estimated that 0.8–1.6% of patients with blunt trauma develop diaphragmatic rupture. However, the diagnosis of this condition is often overlooked, with right-sided hernias missed more frequently than left-sided hernias. Early diagnosis and repair are essential to prevent future complications such as strangulation and ischemia of intra-abdominal organs, lung collapse, and cardiovascular demise.
Case Report: A 17-year-old male (180 cm; 86 kg) with no comorbidities presented to the emergency department (ED) following a high-velocity, unrestricted, rear-ended motor vehicle crash (MVC). The patient was intubated and hemodynamically stabilized in the ED, with planned surgical exploration of the abdomen. Six days following the accident, the patient was extubated; he became increasingly hypoxic and tachypneic over the next day. A CT of the chest and pelvis was ordered, confirming the diagnosis of a post-traumatic right-sided diaphragmatic hernia. An exploratory laparotomy was scheduled. Difficulties with ventilation were encountered due to suspected lung compression by the liver and movement of the endotracheal tube into the right main lung bronchus.
Conclusion: Traumatic diaphragmatic hernia should be considered in all patients presenting with abdominal trauma and should be suspected if respiratory distress arises during the patient’s clinical course. The recommended anesthetic approach is rapid sequence intubation with a cardiovascular-stable agent like etomidate and gastric decompression. Difficulties with intubation and ventilation should be anticipated due to the presence of the visceral organs within the thoracic cavity.
Keywords: Anesthesiology, Hepatothorax, Traumatic diaphragmatic hernia, Diaphragmatic hernia, Trauma, Intra-operative complication.
How to cite : Al-hindawi A, Hamsley S J, Fasbinder S, Fogelman S, Molyneaux I, Delayed presentation of traumatic hepatothorax: An anesthetic and surgical perspective. South Asian J Case Rep Rev 2024;11(1):1-5
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