Karolina Gambus1, Blazej Kuzdzal2*, Janusz Warmus3, Konrad Moszczynski2 and Piotr Kocon4
1Department of Thoracic Surgery, 5th Military Hospital, Poland
2Department of Thoracic Surgery, J. Dietl Hospital, Poland
3Department of Thoracic Surgery, John Paul II Hospital, Poland
4Department of Thoracic Surgery, Jagiellonian University Medical College, Poland
mass. On the chest CTa large volume of fatty tissue and bowel was seen in the anterior mediastinum. There was no history of trauma. An initial diagnosis of Larrey hernia was made and the patient was operated on. Laparotomy revealed a large defect in the tendinous centre of the diaphragm and pericardium with intrapericardial displacement of the omentum and the transverse colon. The viscera were reduced into the abdominal cavity and the defect was closed using a Teflon patch. The patient was questioned again about any trauma in the past and he remembered a car accident 20 years earlier. In the early postoperative course transient atrial fibrillation occurred and next pleural and pericardial effusion was diagnosed, requiring thoracentesis and pericardiocentesis. Further course was uneventful and the patient was discharged home. Although this condition is rare, delayed diagnosis of diaphragmatic and pericardial rupture should be taken into consideration in patients with epigastric symptoms, who sustained torso trauma in the past.
Gambus K, Kuzdzal B, Warmus J, Moszczynski K, Kocon P. Long- Lasting Intrapericardial Displacement of the Transverse Colon Following Diaphragmatic and Pericardial Rupture. Clin Case Rep Int. 2021; 5: 1236.