Porous diaphragm syndrome with recurrent thymoma.

Takayo Ota,Takafumi Okabe,Akira Okimura,Masahiro Fukuoka,Yoshikazu Hasegawa

doi:10.1002/rcr2.391

Takayo Ota, Takafumi Okabe + Show 3 more

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https://doi.org/10.1002/rcr2.391

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Abstract

Porous diaphragm syndrome describes a defect in the diaphragm in which substances pass from the peritoneal cavity to the pleural space. Defects may be congenital or acquired. Acquired defects are caused by the thinning and eventual splitting of collagen fibres in the tendinous part of the diaphragm. We report a case of porous diaphragm syndrome with recurrent thymoma that presented with massive ascites. Increasing intra‐abdominal pressure by ascites and diaphragmatic thinning due to malnutrition by malignancies resulted in the formation of an artificial hole. Thoracentesis changed the balance of hydrostatic pressure, which initiated the influx of a large volume of ascites to the pleural cavity through a hole in the diaphragm.

Highlights

Porous diaphragm syndrome describes a defect in the diaphragm in which substances, such as fluids, blood, gases, tissue, or exudates, pass from the peritoneal cavity to the pleural space [1]
We present a case of porous diaphragm syndrome in which the patient had massive ascites due to recurrent thymoma
Change in hydrostatic pressure gradient across the diaphragm by thoracentesis triggered a sudden onset of dyspnoea caused by the influx of a large volume of ascites into the pleural cavity through a hole in the diaphragm

Summary

Introduction

Porous diaphragm syndrome describes a defect in the diaphragm in which substances, such as fluids, blood, gases, tissue, or exudates, pass from the peritoneal cavity to the pleural space [1]. One of the mechanisms of developing a hole in the diaphragm is through increasing intraabdominal pressure by ascites. We present a case of porous diaphragm syndrome in which the patient had massive ascites due to recurrent thymoma. Change in hydrostatic pressure gradient across the diaphragm by thoracentesis triggered a sudden onset of dyspnoea caused by the influx of a large volume of ascites into the pleural cavity through a hole in the diaphragm.

Results

Conclusion