Mediastinal shift secondary to a diaphragmatic hernia: a life-threatening combination.
An 85-year-old man was referred to our department, with a three-day history of increasing shortness of breath. Following clinical and radiological assessment, diaphragmatic herniation of bowel was identified to be causing mediastinal shift and respiratory distress. An emergency laparotomy identified a massive diaphragmatic defect which was not amenable to primary closure. A colopexy procedure was performed to comparmentalise the abdomen and obliterate the diaphragmatic defect. Despite aggressive treatment in the intensive care unit he died from multi-organ failure. This case highlights an extremely rare and life-threatening cause of mediastinal shift and respiratory distress.
Campbell
A S
AS
Department of Surgery, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AB, Northern Ireland, UK,
O'Donnell
M E
ME
Lee
J
J
D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006548:Hernia, Diaphragmatic / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D008297:Male; D008477:Mediastinal Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D013902:Radiography, Thoracic