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Bowel obstruction secondary to transdiaphragmatic intercostal hernia
Obstrucción intestinal secundaria a hernia intercostal transdiafragmática
Lara Blanco Terés
, Íñigo García Sanz, Cristina Marín Campos, Álvaro Gancedo Quintana, Elena Martín-Pérez
Corresponding author
Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain
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Change in bowel calibre between the ninth and tenth left ribs (arrow).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 67-year-old man with a history of asthma visited the accident and emergency department with vomiting and dyspnoea. A chest X-ray showed complete occupation of the left half of the chest by bowel loops. Computed tomography showed a defect measuring 9 × 6 cm in the middle part of the left diaphragm (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A) and a bulky hernial sac containing virtually all the patient's bowel loops, which were found to be dilated. Part of the bowel contents were herniated between the ninth and tenth left ribs (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B), leading to a change in calibre (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The patient underwent emergency surgery by laparotomy with reduction of the contents to the abdominal cavity, resection of a metre of ischaemic jejunum and anastomosis, with left chest tube placement and repair of the diaphragmatic defect with Gore-Tex mesh. The patient followed a favourable postoperative course.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 999 "Ancho" => 1255 "Tamanyo" => 227242 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Computed tomography (CT) of the chest and abdomen with administration of intravenous contrast. (A) Sagittal slice: diaphragmatic hernia with a hernial orifice measuring 9 × 6 cm (*). (B) Coronal slice: bulky hernial sac in the left chest containing dilated bowel loops up to the apex. Part of the contents were herniated between the ninth and tenth left ribs (arrow).</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 658 "Ancho" => 905 "Tamanyo" => 88795 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Transverse slice of the chest. Change in bowel calibre between the ninth and tenth left ribs (arrow).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Posstraumatic transdiaphragmatic intercostal hernia: report of a case and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V. Kalles" 1 => "M. Dasiou" 2 => "G Doga" 3 => "I Papapanagiotou" 4 => "EA Konstantinou" 5 => "A Mekras" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.9738/INTSURG-D-13-00272.1" "Revista" => array:6 [ "tituloSerie" => "Int Surg" "fecha" => "2015" "volumen" => "100" "paginaInicial" => "444" "paginaFinal" => "449" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25785325" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Giant transdiaphragmatic intercostal hernia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "I. Loumiotis" 1 => "D.P. Ceppa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.athoracsur.2017.03.011" "Revista" => array:5 [ "tituloSerie" => "Ann Thorac Surg" "fecha" => "2017" "volumen" => "104" "paginaInicial" => "e93" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28633277" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transdiaphragmatic intercostal hernia after trauma: a case report, literature review, and discussion of a challenging clinical scenario" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Sapp" 1 => "T. Nowack" 2 => "DB Christie" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0003134820945273" "Revista" => array:3 [ "tituloSerie" => "Ann Surg" "fecha" => "2020" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15912052" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/24443824/0000004500000007/v1_202208200553/S2444382422001183/v1_202208200553/en/main.assets" "Apartado" => array:4 [ "identificador" => "75461" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images of the month" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/24443824/0000004500000007/v1_202208200553/S2444382422001183/v1_202208200553/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382422001183?idApp=UINPBA00004N" ]
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