RESUMO
A 37-year-old man with a past history of a fall from height 16 years previously was admitted with acute abdomen. Investigations revealed intestinal obstruction caused by a diaphragmatic hernia. He had an incarcerated omentum and Richter's hernia of the transverse colon secondary to left diaphragmatic hernia leading to colonic ileus. Following resection of the strangulated omentum and reduction of the colon intraabdominally, a surgical repair of the hernia was performed using an abdominal and transthoracic approach. The relatively rare late complication of a left-sided enterothorax with ileus makes this a remarkable case and underlines the need for early surgery to avoid late complications.
Assuntos
Colo Transverso , Doenças do Colo/etiologia , Doenças do Colo/cirurgia , Hérnia Diafragmática Traumática/complicações , Hérnia Diafragmática Traumática/cirurgia , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Abdome Agudo/etiologia , Adulto , Colo Transverso/diagnóstico por imagem , Colo Transverso/cirurgia , Doenças do Colo/diagnóstico por imagem , Hérnia Diafragmática Traumática/diagnóstico por imagem , Humanos , Obstrução Intestinal/diagnóstico por imagem , Masculino , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/etiologia , Derrame Pleural/cirurgia , Radiografia , ToracotomiaRESUMO
Wegener's granulomatosis is a necrotizing vasculitis of unknown etiology characterized mainly by inflammation of the small- and medium-sized arteries and veins that affect any viscera. It may rarely involve the gastrointestinal tract. Only a few cases of multiple focus ileal perforation due to ulcers associated with Wegener's granulomatosis have been reported. Herein we report a case of a 32-year-old man with extensive intestinal small bowel ischaemic perforation due to Wegener's granulomatosis.