Surgery Today

, Volume 40, Issue 9, pp 874–877 | Cite as

Gangrenous intrathoracic appendicitis, a rare cause of right-sided chest pain: Report of a case

  • Elisabeth Schellhaas
  • Oliver Döbler
  • Anton-J. Kroesen
  • Heinz-J. Buhr
  • Hubert G. Hotz
Case Report

Abstract

Diaphragmatic hernias are becoming increasingly common due to radiofrequency ablation of malignant liver tumors. Most patients eventually present with symptoms caused by bowel obstruction. A 54-year-old woman with pleuritic pain and fever had a right-sided enterothorax probably caused by hemihepatectomy several years before. The patient was diagnosed with perforated gangrenous intrathoracic appendicitis during an emergency laparotomy for suspected incarceration of her diaphragmatic hernia. She was treated with an appendectomy and suturing of her right hemidiaphragm. An acquired diaphragmatic hernia should therefore be surgically repaired as soon as it is diagnosed in order to avoid complications.

Key words

Intrathoracic appendicitis Diaphragmatic hernia Enterothorax Liver surgery 

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References

  1. 1.
    Sadler TW. Medizinische Embryologie. 10th ed. Stuttgart: Thieme; 2003.Google Scholar
  2. 2.
    Sano A, Kato H, Hamatani H, Sakai M, Tanaka N, Inose T, et al. Diaphragmatic hernia with ischemic bowel obstruction in pregnancy: report of a case. Surg Today 2008;38:836–840.CrossRefPubMedGoogle Scholar
  3. 3.
    Grundmann R. Eingriffe am Zwerchfell. In: Pichlmaier H, Schildberg FW, editors. Thoraxchirurgie. 3rd ed. Berlin Heidelberg: Springer; 2006. p. 213–227.Google Scholar
  4. 4.
    Rubikas R. Diaphragmatic injuries. Eur J Cardiothorac Surg 2001;20:53–57.CrossRefPubMedGoogle Scholar
  5. 5.
    Reber PU, Schmied B, Seiler CA, Baer HU, Patel AG, Buchler MW. Missed diaphragmatic injuries and their long-term sequelae. J Trauma 1998;44(1):183–188.CrossRefPubMedGoogle Scholar
  6. 6.
    Hemming AW, Reed AI, Langham MR, Fujita S, van der Werf WJ, Howard RJ. Hepatic vein reconstruction for resection of hepatic tumors. Ann Surg 2002;235(6):850–858.CrossRefPubMedGoogle Scholar
  7. 7.
    Barakat MJ, Vickers JH. Necrotic gangrenous intrathoracic appendix in a marfanoid adult patient: a case report. BMC Surg 2005;5:4.CrossRefPubMedGoogle Scholar
  8. 8.
    Koda M, Ueki M, Maeda N, Murawaki Y. Diaphragmatic perforation and hernia after hepatic radiofrequency ablation. AJR 2003;180:1561–1562.PubMedGoogle Scholar
  9. 9.
    Shibuya A, Nakazawa T, Saigenji K, Furuta K, Matsunaga K. Diaphragmatic hernia after radiofrequency ablation therapy for hepatocellular carcinoma. AJR 2006;186:S241–S243.CrossRefPubMedGoogle Scholar
  10. 10.
    Di Francesco F, di Sandro S, Doria C, Ramirez C, Iaria M, Navarro V, et al. Diaphragmatic hernia occurring 15 months after percutaneous radiofrequency ablation of a hepatocellular cancer. Am Surg 2008;74(2):129–132.PubMedGoogle Scholar
  11. 11.
    McCabe AJ, Orr JD, Sharif K, de Ville de Goyet J. Right-sided diaphragmatic hernia in infants after liver transplantation. J Pediatr Surg 2005;40:1181–1184.CrossRefPubMedGoogle Scholar
  12. 12.
    Okajima H, Hayashida S, Iwasaki H, Suda H, Takeichi T, Ueno M, et al. Bowel obstruction due to diaphragmatic hernia in an elder child after pediatric liver transplantation. Pediatr Transplant 2007;11:324–326.CrossRefPubMedGoogle Scholar
  13. 13.
    Hawxby AM, Mason DP, Klein AS. Diaphragmatic hernia after right donor and hepatectomy: a rare donor complication of partial hepatectomy for transplantation. Hepatobiliary Pancreat Dis Int 2006;5(3):459–461.PubMedGoogle Scholar
  14. 14.
    Pappas-Gogos G, Karfis EA, Kakadellis J, Tsimoyiannis EC. Intrathoracic cancer of the splenic flexure (abstract). Hernia 2007;11(3):257–259.CrossRefPubMedGoogle Scholar

Copyright information

© Springer 2010

Authors and Affiliations

  • Elisabeth Schellhaas
    • 1
  • Oliver Döbler
    • 1
  • Anton-J. Kroesen
    • 1
  • Heinz-J. Buhr
    • 1
  • Hubert G. Hotz
    • 1
  1. 1.Department of Surgery ICharité Medical SchoolBerlinGermany

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