title: [Clinical case--voluminous diaphragmatic hernia--surgically acute abdomen: diagnostic and therapeutical challenges].
abstract: We present the case of a 58-year old male patient admitted in the surgery section of the University Emergency Hospital of Bucharest and diagnosed with acute abdomen. The minimal clinical-paraclinical investigation (i.e., thorax-pulmonary Xray, biological probes) raises questions as to the differentiated diagnosis and other associated diseases, also suggesting the existence of voluminous diaphragmatic hernia. The CT thorax-abdomen examination confirms the diaphragmatic hernia suspicion, with intra-thorax ascent of the colon up to the anterior C4 level, but does not explain the abdominal suffering; thus we suspected a biliary ileus or acute appendicitis. Medial laparotomy was imperative. Intrasurgically peritonitis was noticed located by gangrenous acute apendicitis, perforated, with coprolite, for which apendictomy and lavage-drainage pf the peritoneal cavity was performed. Post-surgical status: favourable to recovery.
authors.affiliation: Universitatea de Medicină şi Farmacie "Carol Davila", Bucureşti, România. dumitrescu_v_dan@yahoo.com
authors.forename: D
authors.initials: D
authors.lastname: Dumitrescu
authors.forename: C
authors.initials: C
authors.lastname: Savlovschi
authors.forename: R
authors.initials: R
authors.lastname: Borcan
authors.forename: H
authors.initials: H
authors.lastname: Pantu
authors.forename: D
authors.initials: D
authors.lastname: Serban
authors.forename: S
authors.initials: S
authors.lastname: Gradinaru
authors.forename: G
authors.initials: G
authors.lastname: Smarandache
authors.forename: T
authors.initials: T
authors.lastname: Trotea
authors.forename: C
authors.initials: C
authors.lastname: Branescu
authors.forename: L
authors.initials: L
authors.lastname: Musat
authors.forename: M
authors.initials: M
authors.lastname: Comandasu
authors.forename: M
authors.initials: M
authors.lastname: Priboi
authors.forename: M
authors.initials: M
authors.lastname: Baldir
authors.forename: B
authors.initials: B
authors.lastname: Sandolache
authors.forename: S
authors.initials: S
authors.lastname: Oprescu
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D001064:Appendicitis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D003937:Diagnosis, Differential; D006548:Hernia, Diaphragmatic / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000150:complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome