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Tension Faecopneumothorax: A Rare Complication of Ruptured Morgagni Diaphragmatic Hernia: Case Report and Review of Literature
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A5607 - Tension Faecopneumothorax: A Rare Complication of Ruptured Morgagni Diaphragmatic Hernia: Case Report and Review of Literature
Author Block: T. E. D. Abdelgalil, S. Yahia, A. Shabaan, M. Sabry; Pediatrics, Mansoura University, Mansoura, Egypt.
Introduction: Fecopneumothorax is a rare clinical presentation that may complicate traumatic diaphragmatic injury with subsequent intestinal perforation. We report a rare case of Fecopneumothorax in a- 4-year old Egyptian girl due to perforated, late presenting, congenital diaphragmatic hernia; Morgagni type.
Case Report: A 4 years female child presented to our hospital with history of vomiting , abdominal pain , high grade fever for 1 week, followed 3 days later by cough, dyspnea and orthopnea. She received antibiotics without improvement, with past history of chronic constipation, no past history of trauma or chest problems. In the emergency department of our hospital, the patient was toxic, drowsy, hypotensive and tachycardic with severe respiratory distress. Examination and targeted investigations revealed the presence of left tension fecopneumothorax complicating congenital diaphragmatic hernia. Intercostal tube was inserted and antibiotics were given followed by surgical repair. The patient improved and discharged. To the best of our knowledge, this is the first reported case of tension fecopneumothorax secondary to congenital diaphragmatic hernia in a child.
Novelty and Importance: Three important clinical lessons are highlighted: (a) Tension hydropneumothorax associated with rapidly accumulating turbid yellow fluid should raise the suspicion of perforated intrathoracic intestine. (b) In the presence of a tension pneumothorax and diaphragmatic hernia, the contents of the visceral sac may be completely reduced and the hernia may be masked. (c) Fecopneumothorax may complicate congenital diaphragmatic hernia and not only the traumatic one.
Ruptured Congenital Morgagni Hernia, though extremely unusual, should be considered in the differential diagnosis of a child presenting accidentally with tension fecopneumothorax
Author Block: T. E. D. Abdelgalil, S. Yahia, A. Shabaan, M. Sabry; Pediatrics, Mansoura University, Mansoura, Egypt.
Introduction: Fecopneumothorax is a rare clinical presentation that may complicate traumatic diaphragmatic injury with subsequent intestinal perforation. We report a rare case of Fecopneumothorax in a- 4-year old Egyptian girl due to perforated, late presenting, congenital diaphragmatic hernia; Morgagni type.
Case Report: A 4 years female child presented to our hospital with history of vomiting , abdominal pain , high grade fever for 1 week, followed 3 days later by cough, dyspnea and orthopnea. She received antibiotics without improvement, with past history of chronic constipation, no past history of trauma or chest problems. In the emergency department of our hospital, the patient was toxic, drowsy, hypotensive and tachycardic with severe respiratory distress. Examination and targeted investigations revealed the presence of left tension fecopneumothorax complicating congenital diaphragmatic hernia. Intercostal tube was inserted and antibiotics were given followed by surgical repair. The patient improved and discharged. To the best of our knowledge, this is the first reported case of tension fecopneumothorax secondary to congenital diaphragmatic hernia in a child.
Novelty and Importance: Three important clinical lessons are highlighted: (a) Tension hydropneumothorax associated with rapidly accumulating turbid yellow fluid should raise the suspicion of perforated intrathoracic intestine. (b) In the presence of a tension pneumothorax and diaphragmatic hernia, the contents of the visceral sac may be completely reduced and the hernia may be masked. (c) Fecopneumothorax may complicate congenital diaphragmatic hernia and not only the traumatic one.
Ruptured Congenital Morgagni Hernia, though extremely unusual, should be considered in the differential diagnosis of a child presenting accidentally with tension fecopneumothorax
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