Post-menopausal acquired diaphragmatic herniation in the context of endometriosis

Singh, Tejas P., Rizvi, Syed A.A., and Pretorius, Casper F. (2018) Post-menopausal acquired diaphragmatic herniation in the context of endometriosis. International Journal of Surgery Case Reports, 53. pp. 154-156.

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Abstract

Introduction: Acquired diaphragmatic hernias are most commonly associated with traumatic thoracic injury and rarely heal spontaneously. Conditions that promote peritoneal seeding, such as endometriosis, are associated with spontaneous acquired diaphragmatic hernia formation. Non-traumatic acquired diaphragmatic herniation has previously been described in the context of catamenial pneumothorax, however post-menopausal endometriotic diaphragmatic herniation has not been previously reported.

Presentation of case: A 57 year old post-menopausal female presented with a strangulated ischaemic loop of small bowel herniating through an acquired right sided endometriotic diaphragmatic hernia not previously visualised on imaging. Clamshell thoracolaparotomy was conducted and the necrotic section of small bowel was resected. The diaphragm was repaired and the patient recovered post-operatively without complications.

Discussion: This patient had a complete intestinal malrotation presenting acutely with a small bowel obstruction and herniation through an acquired diaphragmatic rupture. This was possibly related to a diaphragmatic defect caused by endometriosis.

Conclusion: We presented a case of a post-menopausal acquired diaphragmatic herniation secondary to endometriosis; resulting in acute intestinal obstruction and bowel infarction. To our knowledge, such a case has not been previously reported in existing literature.

Item ID: 56162
Item Type: Article (Case Study)
ISSN: 2210-2612
Copyright Information: Copyright © 2018 The Author(s). This is an open access article under the CC BY license(http://creativecommons.org/licenses/by/4.0/).
Funders: Queensland Government (QG)
Projects and Grants: QG Junior Doctor Research Fellowship
Date Deposited: 20 Nov 2018 22:39
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110323 Surgery @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920118 Surgical Methods and Procedures @ 100%
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