Abstract
A congenital diaphragmatic hernia is very uncommon among adults. A diaphragmatic hernia is primarily acute in onset and it is usually identified after trauma. It occurs mostly on the left side. We would like to report a 68-year-old male who presented with a 4-day history of acute intestinal obstruction with a background history of change in bowel habit for a month secondary to a right diaphragmatic hernia. He did not have any history of trauma. Clinical examination revealed a distended abdomen with high pitched bowel sound and no palpable mass. The right lung was inaudible on auscultation. Computed tomography scan was consistent with a right diaphragmatic hernia and acute intestinal obstruction. We highlight the late onset of a congenital diaphragmatic hernia and emphasize the vital need for perioperative management to ensure a promising surgical outcome.
Keywords :
Diaphragmatic hernia,
intestinal obstruction,
multislice computed tomography,
Abstrak
Angin pasang otot diafragma kongenital sangat jarang berlaku terutamanya di kalangan orang dewasa. Ia selalunya terjadi selepas kemalangan dan kebiasaannya melibatkan otot diafragma di sebelah kiri. Kami ingin membincangkan satu kes seorang lelaki berumur 68 tahun yang datang dengan masalah usus tersumbat akut disebabkan oleh angin pasang otot diafragma di sebelah kanan. Pemeriksaan klinikal menunjukkan abdomen yang kembung dengan bunyi usus bernada tinggi dan tiada ketulan di dalamnya. Pemeriksaan juga menunjukkan bahawa tiada bunyi pernafasan di dada sebelah kanan. Imbasan tomografi adalah konsisten dengan angin pasang otot diafragma dan usus tersumbat akut. Kami mengetengahkan kes angin pasang otot diafragma kongenital dan menekankan pentingnya untuk pengurusan perioperatif bagi memastikan hasil pembedahan yang berjaya.
Kata Kunci :
angin pasang otot diaphragma,
imbasan tomografi multi-hirisan,
usus tersumbat,
Correspondance Address
Firdaus Hayati. Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia. Tel: +6088-320000 ext. 611029 E-mail: firdaushayati@gmail.com, m_firdaus@ums.edu.my
