Faecopneumothorax revealing a neglected traumatic diaphragmatic hernia

Abstract

Introduction: Tension fecopneumothoraxis a rare but serious complication of traumatic diaphragmatic hernias. The diagnosis of the hernia can be delayed from a few days to some years and will be made on occasion of complications representing the dramatic evolution of the “latent stage” of disease. Only few cases of post-traumatic faecopneumothorax are described in the literature. This clinical evolution is associated to a significant increase in morbidity (30–80% of cases). This is particularly the case with our patient. Case presentation: We report the case of a 26-year-old who had a trauma of the left hypochondrium about a year ago and who presented an acute intestinal occlusion, an X ray abdomen and chest was performed, showing abundant hydropneumothorax, thethoracoabdominal scan reveals an abundant effusion with heterogeneous density in the left pleural cavity, associated with an intrapleural hernia of the large intestine Discussion: Tension fecopneumothorax is a very rare complication of traumatic diaphragmatic hernia, only few cases are described in the literature, the mechanisms of the injury can blunt or penetrating, it occurs after intrapleural perforation of a strangulated colon, and very often its life threatening. Conclusion: According to our knowledge and review of the literature, Tension fecopneumothorax complicating a traumatic diaphragmatic hernia is very rare; the diagnosis is made by thoracic radiography and thoracoabdominalCT, which also allow orientation of the therapeutic attitude with non-negligible post-operative complications.