Shaher Abdulaziz, Alqahtani Abdulrahman Mohmmed, Sinnah Khalid N, Al Bakheet Shaher Mousa
Department of General Surgery, Armed Forces Hospitals Southern Region, Riyadh, Saudi Arabia.
Trauma and Acute Care Surgery, King Saud University Medical City, Riyadh, Saudi Arabia.
BMJ Case Rep. 2019 Jun 22;12(6):e229475. doi: 10.1136/bcr-2019-229475.
Diaphragmatic eventration is a rare entity in the adult population, and usually asymptomatic ; our case is a young man with severe right-sided diaphragmatic eventration with huge dilated colon that has compromised the right hemithorax and caused complete lung collapse and mediastinal shift similar to tension pneumothorax picture with haemodynamic alteration. A single similar case report had been published but did not shed the light on the accurate description of the pathophysiological mechanism of the disease. We believe that such a high abdominal pressure that has transmitted to the thoracic cavity due to the pliable diaphragm causing such a derangment in both the anatomy and the physiology deserves reporting and we think that the term 'thoracoabdominal compartment syndrome' describes it accurately, so we discuss some learning points from our case and things that could have been done better.
膈膨出在成人中是一种罕见病症,通常无症状;我们的病例是一名年轻男性,患有严重的右侧膈膨出,伴有巨大扩张的结肠,已压迫右半胸并导致完全性肺萎陷和纵隔移位,类似于伴有血流动力学改变的张力性气胸表现。此前已发表过一篇类似病例报告,但未阐明该疾病病理生理机制的准确描述。我们认为,由于膈膜柔韧,导致高腹压传递至胸腔,进而引起解剖和生理上的紊乱,这种情况值得报告,并且我们认为“胸腹间隔综合征”这一术语能准确描述它,因此我们讨论了该病例的一些经验教训以及本可做得更好的方面。