ABSTRACT
BACKGROUND: Small congenital diaphragmatic defects are usually occult, but can present as a problem in patients with increased abdominal fluid as unilateral massive hydrothorax. We present a unique case presentation of a small congenital diaphragmatic defect. CASE REPORT: A 79 female immediately postoperatively developed a hydrothorax following low anterior resection for rectal cancer. The hydrothorax turned out to be due to an intrabdominal bleed in a patient with a previously undiagnosed congenital diaphragmatic hernia. The respiratory ball value mechanism worked as a pump to move blood from the abdomen to the chest and caused a tension hemothorax. RESULTS: Surgeons should be aware that a post operative hydrothorax could be associated with an intrabdominal complication of recent surgery. CONCLUSIONS: A small occult congenital diaphragmatic defect and associated ball value mechanism may provide an unexpected but clinically significant communication between the abdominal and thoracic cavities.
Subject(s)
Abdomen/surgery , Hemothorax/etiology , Hernias, Diaphragmatic, Congenital , Surgical Procedures, Operative/adverse effects , Aged , Female , HumansABSTRACT
A case of cystadenoma of the common bile-duct with areas of carcinoma in situ in a 61 year old woman is presented. Pre-operative investigations may confuse this rare tumour with the more common choledochal cyst although this case raises the possibility that this neoplasm may have arisen within a longstanding choledochal cyst. Due to the risk of malignant transformation, complete excision of any cystic lesion of the bile-duct is recommended.
