title: Tension pneumothorax due to perforated colon.
abstract: A very rare case of traumatic diaphragmatic hernia is reported in a 65-year-old woman who presented 46 years after her initial thoracoabdominal injury with tension faecopneumothorax caused by a perforated colon in the chest cavity. She presented in a critical condition with severe respiratory distress, sepsis and acute kidney injury. She had a long-standing history of bronchial asthma with respiratory complications and had experienced progressive shortness of breath for the past year. A recent CT scan had excluded the presence of a diaphragmatic hernia but showed a significantly raised left hemidiaphragm. On admission, chest X-rays showed a significantly raised left hemidiaphragm and mediastinal shift, but the possibility of a diaphragmatic hernia with strangulated bowel in the chest was not suspected until the patient was reviewed by the surgical and intensive care unit consultants the next morning and a repeat CT performed. She had a successful outcome after her emergency operation.
authors.affiliation: Department of General Surgery, The Dudley Group NHS Foundation Trust, Dudley, UK.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Abdullah
authors.affiliation: Department of General Surgery, Russells Hall Hospital, Dudley, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Stonelake
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000368:Aged; D003106:Colon / Q000293:injuries; D003937:Diagnosis, Differential; D005260:Female; D006549:Hernia, Diaphragmatic, Traumatic / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis / Q000209:etiology*; D011030:Pneumothorax / Q000175:diagnosis / Q000209:etiology*; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed