AI Article Synopsis
- - The patient, a typically healthy 25-year-old man, presented to the A&E with severe symptoms that were initially thought to be due to a tension pneumothorax, leading to procedures like needle thoracocentesis and chest drain insertion.
- - A chest x-ray and emergency CT scan revealed a Bochdalek diaphragmatic hernia, causing significant lung collapse due to the spleen and bowel displacement.
- - The patient underwent surgery to reposition the bowel, repair the diaphragm, and perform a sleeve gastrectomy, experiencing a complicated recovery in the intensive therapy unit, including several complications like wound issues and fluid overload.
Article Abstract
The patient was an otherwise usually fit and well 25-year-old man who presented to A&E department in extremis. The initial working diagnosis was a tension pneumothorax, and he was subsequently treated with needle thoracocentesis causing a release of air. A chest radiograph was taken, after which a chest drain was inserted. Bilious fluid was drained from the chest drain. The patient was taken for an emergency CT, which demonstrated a Bochdalek diaphragmatic hernia, with the spleen and bowel found to be causing a near total left lung collapse. He was taken to the theatre to return the bowel to the correct anatomical position, in addition to undergoing a sleeve gastrectomy, and diaphragmatic defect repair. The patient has had a complex and protracted recovery in the intensive therapy unit (ITU) with complications including wound dehiscence, gastrectomy leak requiring additional surgical repair, fluid overload and bilateral pleural empyema.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4024963 | PMC |
| http://dx.doi.org/10.1136/bcr-2013-203435 | DOI Listing |
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