title: Late complication of diaphragmatic gunshot injury: appendix perforation due to colon incarceration.
abstract: Missing the diaphragmatic injury on first admission is often associated with late complications. A 38 year-old male patient is presented here as a case of missed diaphragmatic injury due to gunshot injury resulted with fecal peritonitis. Celiotomy revealed a distended appendix perforation due to herniated left colon obstruction through the left pleural cavity. Left colon and stomach were reduced to peritoneal cavity and diaphragm was repaired with interrupted polypropylene sutures. After being sure about the viability of the colon and stomach, appendectomy with cecal exteriorization was performed. Postoperative period was uneventful. The patient was discharged on the 10th postoperative day. A thorough inspection of the diaphragm is essential in thoraco-abdominal trauma. Repair of the diaphragmatic defects should invariably carried out to avoid life-threatening complications.
authors.affiliation: Department of General Surgery, Istanbul University Cerrahpaşa Medical Faculty, Istanbul, Turkey.
authors.forename: Bilgi
authors.initials: B
authors.lastname: Baca
authors.forename: Tayfun
authors.initials: T
authors.lastname: Karahasanoğlu
authors.forename: Kaya
authors.initials: K
authors.lastname: Saribeyoğlu
authors.forename: Pinar
authors.initials: P
authors.lastname: Arica
authors.forename: Ece
authors.initials: E
authors.lastname: Kol
mesh_terms: D000328:Adult; D001065:Appendix / Q000293:injuries* / Q000601:surgery; D003108:Colonic Diseases / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D006549:Hernia, Diaphragmatic, Traumatic / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008297:Male; D011859:Radiography; D014948:Wounds, Gunshot