Pleurocutaneous Fistulas of Fecopneumothorax: Unusual Complications of Penetrating Thoracic Trauma Due to Zebu Gord

Yıl 2020, , 80 - 86, 23.06.2020

Narindra Njarasoa Mihaja Razafimanjato Odilon G Tsiambanizafy Tsiry Dn Ravelomihary Manjakaniaina Ravoatrarilandy Auberlin F Rakototitana Hanitrala Jl Rakotovao

https://doi.org/10.5455/umj.20200422034809

Öz

Introduction: Our case highlights an extremely rare colopleural fistula in the setting of post-traumatic diaphragmatic hernia following penetrating wound thoracic of zebu gord with delayed presentation, suspected clinic-radiologically and confirmed on surgery.
Case presentation: A 60-year old moribund male with three months history of open-chest penetrating due to zebu gord, came to the emergency department with a clinical presentation of sepsis syndrome and a deterioration of the general status. On examination, the patient cachectic presented a fecopurulent liquid drainage from an orifice in the anterolateral region of left hemithorax with necrotizing fasciitis. A chest X-ray showed uncompressing hydropneumothorax in the left pleural cavity.
Conclusion: The patient we report had the most serious complications of post-traumatic diaphragmatic hernia, fecopneumothorax, pleurocutaneous fistula, and necrotizing fasciitis. An emergency laparotomy was carried out. The problem was successfully treated by colon resection anastomosis, pleurectomy, and negative pressure therapy.

Anahtar Kelimeler

Fistula, fecopneumothorax, Thoracic Trauma

Kaynakça

• Chern TY, Kwok A & Putnis S. A case of tension faecopneumothorax after delayed diagnosis of traumatic diaphragmatic hernia. Surg Case Rep 2018;4(1):1-5.
• Seelig MH, Klingler PJ & Scho K. Tension fecopneumothorax due to colonic perforation in a diaphragmatic hernia. Chest 1999;115(1):288-91.
• Vermillion J, Wilson E & Smith R. Traumatic diaphragmatic hernia presenting as a tension fecopneumothorax. Hernia 2001;5(3):158-60.
• Ibrahim WH & Thomas L. Sister Leena's sign: a sign that may be useful in differentiating colopleural fistula (fecal empyema) from usual empyema. Chest 2007;131(5):1616-7.
• Radin DR, Ray MJ, Halls JM. Strangulated diaphragmatic hernia with pneumothorax due to colopleural fistula. Am J Roentgenol 1986;146:321-2.
• Jarry J, Razafindratsira T, Lepront D, et al. Tension faecopneumothorax as the rare presenting feature of a traumatic diaphragmatic hernia. Ann Chir 2006;131:48-50.
• Duzgun AP, Ozmen MM, Saylam B, et al. Factors influencing mortality in traumatic rupture of diaphragm. Ulus Travma Acil Cerrahi Derg 2008;14:132–8.
• Mahmodlou R, &Abbasyvash R. The early fecopneumothorax due to simultaneous colonic perforation and herniation through diaphragmatic laceration: within 6 days. Indian J Thorac Cardiovasc Surg 2011;27(3):144.
• Rabenjamina FR, &Rakotozafy G. Une plaie abdomino-diaphragmatique droite par encornement de zébu. Ann Chir 2000;125(5):497.
• Chatzoulis G, Papachristos IC, Daliakopoulos SI et al. Septic shock with tension fecothorax as a delayed presentation of a gunshot diaphragmatic rupture. J Thorac Dis 2013;5(5):E195.
• Mohite PN, Mistry JH, Mehta H, et al. Ascaris worm in the intercostal drainage bag: inadvertent intercostal tube insertion into jejunum: a case report. J Cardio thorac Surg 2010;5(1):125.
• Grimes OF. Traumatic injuries of the diaphragm. Diaphragmatic hernia. Am J Surg 1974;128(2):175–81.
• Hayashi A, Susaki Y, Ose N, et al. Colopleural fistula caused by aspergillus: an extremely rare complication after lung resection - case report. Surg Case Rep 2016;2(1):1-5.
• Olubaniyi BO, Fontaine EJ, & Page RD. Colo-pleural fistula following pneumonectomy. Eur J Cardiothorac Surg 2006;30(6):950-1.
• Abdullah M, & Stonelake P. Tension pneumothorax due to perforated colon. BMJ Case Rep 2016. doi:10.1136/bcr-2016-215325.
• Rashid F, Chakrabarty MM, Singh R, et al. A review on delayed presentation of diaphragmatic rupture. World J Emerg Surg 2009;4:32.
• Komatsu T & Henteleff H. Colopleural fistula with atypical presentation as a complication of diaphragmatic hernia repair. Ann Thorac Surg 2010;90(2):662-3.
• Powell BS, Magnotti LJ, Schroeppel TJ et al. Diagnostic laparoscopy for the evaluation of occult diaphragmatic injury following penetrating thoracoabdominal trauma. Injury 2008;39(5):530–4.
• Barišiæ G, Krivokapiae Z, Adžiæ T et al. Fecopneumothorax and colopleural fistula–uncommon complications of Crohn's disease. BMC Gastroenterol. 2006;6(1)17.
• Yucel M, Bas G, Kulali F, et al. Evolution of diaphragm in penetrating left thoracoabdominal stab injuries: the role of multislice computed tomography. Injury 2015;46(9):1734–7.
• Razafimanjato NNM, Ravelomihary TDN, Ravoatrarilandy M, et al. Necrotizing fasciitis of the chest wall: our preliminary results on the 14 observations treated by negative pressure. J Func Vent Pulm 2018;9:27.
• Kelly J, Condon E, Kirwan W, et al. Post-traumatic tension faecopneumothorax in a young male: case report. World J Emerg Surg 2008;3:20.