title: [Hepatic cholestasis resulting from a long-standing enterothorax: a case report].
abstract: BACKGROUND
  Due to the lack of symptoms an enterothorax frequently remains undetected in adults. Most symptomatic patients complain about bowel obstruction and a surgical repair of the diaphragmatic defect, particularly with a mesh, is mandatory.
  
  
  METHODS
  This report presents the case of a 72-year-old female patient with a history of an upside-down stomach presenting with a painless jaundice and signs of liver cirrhosis.
  
  
  METHODS
  The preoperative work-up revealed an enterothorax with compression of the main bile duct. Explorative laparotomy showed a liver cirrhosis with distinct intrahepatic cholestasis, a hydropic gallbladder and confirmed a right-sided diaphragmatic defect with an enterothorax. After reposition of the intestine, a cholecystectomy, bile duct revision and the closure of the diaphragmatic defect using a mesh were performed.
  
  
  CONCLUSIONS
  Diaphragmatic defects are the basis for the formation of an enterothorax which may be associated with a complicated clinical course. Therefore, in cases of coincidental diagnosis, even in asymptomatic patients, surgical repair should be performed in order to prevent serious complications as presented in this case.
authors.affiliation: Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Ambe
authors.forename: D
authors.initials: D
authors.lastname: Häussinger
authors.forename: V
authors.initials: V
authors.lastname: Schneitler
authors.forename: J G
authors.initials: JG
authors.lastname: Bode
authors.forename: R S
authors.initials: RS
authors.lastname: Lanzman
authors.forename: W T
authors.initials: WT
authors.lastname: Knoefel
authors.forename: D
authors.initials: D
authors.lastname: Vallböhmer
mesh_terms: D000368:Aged; D002780:Cholestasis, Intrahepatic / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D003937:Diagnosis, Differential; D005260:Female; D006548:Hernia, Diaphragmatic / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D016896:Treatment Outcome