Porous diaphragm syndrome presenting as hemothorax secondary to hemoperitoneum after laparoscopic myomectomy: A case report and literature review.
diaphragm
hemothorax
laparoscopy
myomectomy
pleural effusion
Journal
The journal of obstetrics and gynaecology research
ISSN: 1447-0756
Titre abrégé: J Obstet Gynaecol Res
Pays: Australia
ID NLM: 9612761
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
revised:
16
12
2021
received:
26
05
2021
accepted:
21
01
2022
pubmed:
16
2
2022
medline:
6
4
2022
entrez:
15
2
2022
Statut:
ppublish
Résumé
Porous diaphragm syndrome includes all pleural cavity conditions, including pleural effusion, hemothorax, or pneumothorax, that occur secondary to peritoneal cavity disorders through defects in the diaphragm. In this report, we describe the first known case of porous diaphragm syndrome presenting as hemothorax after laparoscopic myomectomy. A 46-year-old nulliparous woman underwent laparoscopic myomectomy for multiple fibroids. Eight hours after surgery, the patient developed exertional dyspnea followed by hemoptysis. Radiological diagnosis revealed massive hemothorax in the right thoracic cavity. Thoracoscopic findings showed the presence of small fenestrae at the center of the right diaphragm, which were repaired thoracoscopically. Hence, quick postoperative diagnosis resulted in successful treatment. In this case, porous diaphragm syndrome is believed to be caused by retention of intraoperative bleed and saline from intra-abdominal lavage, in the abdominal cavity. Porous diaphragm syndrome is a potential life-threatening condition that gynecological surgeons should consider in this era of laparoscopic surgery.
Types de publication
Case Reports
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1039-1045Subventions
Organisme : Japan Society for the Promotion of Science
ID : 18K09976
Organisme : Japan Society for the Promotion of Science
ID : 19K10486
Informations de copyright
© 2022 Japan Society of Obstetrics and Gynecology.
Références
Walker SP, Morley AJ, Stadon L, de Fonseka D, Arnold DT, Medford ARL, et al. Nonmalignant pleural effusions: a prospective study of 356 consecutive unselected patients. Chest. 2017;151(5):1099-105.
Huang PM, Chang YL, Yang CY, Lee YC. The morphology of diaphragmatic defects in hepatic hydrothorax: thoracoscopic finding. J Thorac Cardiovasc Surg. 2005;130(1):141-5.
Edwards SR, Unger AM. Acute hydrothorax-a new complication of peritoneal dialysis. JAMA. 1967;199(11):853-5.
Singh A, Bajwa A, Shujaat A. Evidence-based review of the management of hepatic hydrothorax. Respiration. 2013;86(2):155-73.
Kirschner PA. Porous diaphragm syndromes. Chest Surg Clin N Am. 1998;8(2):449-72.
May J, Ades A. Porous diaphragm syndrome: haemothorax secondary to haemoperitoneum following laparoscopic hysterectomy. BMJ Case Rep. 2013;2013:bcr2013201088.
Saito F, Tashiro H, Honda R, Ohtake H, Katabuchi H. Twisted ovarian tumor causing progressive hemothorax: a case report of porous diaphragm syndrome. Gynecol Obstet Investig. 2008;66(2):134-7.
Vaughan P, Hooper PJ, Duffy JP. Spontaneous hemothorax after caesarian section: an unusual manifestation of diaphragmatic fenestrations. Ann Thorac Surg. 2005;80(4):1517-9.
Childers JM, Caplinger P. Spontaneous pneumothorax during operative laparoscopy secondary to congenital diaphragmatic defects. A case report. J Reprod Med. 1995;40(2):151-3.
Singh S, Vaidya P, Dale A, Morgan B. Massive hydrothorax complicating continuous ambulatory peritoneal dialysis. Nephron. 1983;34(3):168-72.
Manabe T, Ono K, Oka S, Kawamura Y, Osaki T. A case of pleuroperitoneal communication in which establishing a laparoscopic pneumoperitoneum was useful for the detection of a fistula. Surg Case Rep. 2021;7(1):64.