Tension pneumothorax from large bowelherniation and perforation as a late presentation of traumatic diaphragmatic hernia during pregnancy: a case report
Dublin Core
Title
Tension pneumothorax from large bowelherniation and perforation as a late presentation of traumatic diaphragmatic hernia during pregnancy: a case report
Subject
Diaphragmatic hernia, Large bowel perforation, Empyema, Tension pneumothorax, Pregnancy, Dyspnea
Description
Abstract
Background Diaphragmatic hernias can be congenital or acquired, with trauma being the primary cause of the
latter. Both types may have delayed presentations, with abdominal organs protruding into the thoracic cavity, causing
symptoms of varying severity. Pregnancy can sometimes precipitate the condition. Tension pneumothorax resulting
from bowel perforation into the thorax is exceptionally rare, with only a few cases reported. To the best of the authors
knowledge, this is the third documented case of a late-presenting trauma-related diaphragmatic hernia during
pregnancy, complicated by tension pneumothorax.
Case presentation A 30-year-old woman, 29 weeks pregnant, was referred to Semmelweis University emergency
department with moderate dyspnea. Initial investigation revealed tension pneumothorax. Chest tube placement
released air, pus, and feces. Computer tomography identified a diaphragmatic hernia with bowel incarceration and
perforation as the underlying cause. The patient underwent a delayed cesarean section and surgical repair, with a
good outcome. A history of thoracic trauma eight years prior was later revealed.
Conclusion Evaluating pregnant patients with shortness of breath in the emergency department is challenging.
Identifying a history of thoracic or abdominal trauma is crucial, as this can raise the suspicion of diaphragmatic hernia,
which can present with a wide range of symptoms. Spontaneous tension pneumothorax in pregnant women is
extremely rare and requires cautious management. A multidisciplinary approach is crucial for the successful treatment
of maternal diaphragmatic hernia.
Keywords Diaphragmatic hernia, Large bowel perforation, Empyema, Tension pneumothorax, Pregnancy, Dyspnea
Background Diaphragmatic hernias can be congenital or acquired, with trauma being the primary cause of the
latter. Both types may have delayed presentations, with abdominal organs protruding into the thoracic cavity, causing
symptoms of varying severity. Pregnancy can sometimes precipitate the condition. Tension pneumothorax resulting
from bowel perforation into the thorax is exceptionally rare, with only a few cases reported. To the best of the authors
knowledge, this is the third documented case of a late-presenting trauma-related diaphragmatic hernia during
pregnancy, complicated by tension pneumothorax.
Case presentation A 30-year-old woman, 29 weeks pregnant, was referred to Semmelweis University emergency
department with moderate dyspnea. Initial investigation revealed tension pneumothorax. Chest tube placement
released air, pus, and feces. Computer tomography identified a diaphragmatic hernia with bowel incarceration and
perforation as the underlying cause. The patient underwent a delayed cesarean section and surgical repair, with a
good outcome. A history of thoracic trauma eight years prior was later revealed.
Conclusion Evaluating pregnant patients with shortness of breath in the emergency department is challenging.
Identifying a history of thoracic or abdominal trauma is crucial, as this can raise the suspicion of diaphragmatic hernia,
which can present with a wide range of symptoms. Spontaneous tension pneumothorax in pregnant women is
extremely rare and requires cautious management. A multidisciplinary approach is crucial for the successful treatment
of maternal diaphragmatic hernia.
Keywords Diaphragmatic hernia, Large bowel perforation, Empyema, Tension pneumothorax, Pregnancy, Dyspnea
Creator
Ákos Sóti1*, Gábor Nagy1
, Zoltán Győri2
, Tamás Vass3
, László Hetzman1
, Bánk Gábor Fenyves1
and Csaba Varga1
, Zoltán Győri2
, Tamás Vass3
, László Hetzman1
, Bánk Gábor Fenyves1
and Csaba Varga1
Source
https://doi.org/10.1186/s12245-025-00843-1
Date
2025
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Ákos Sóti1*, Gábor Nagy1
, Zoltán Győri2
, Tamás Vass3
, László Hetzman1
, Bánk Gábor Fenyves1
and Csaba Varga1, “Tension pneumothorax from large bowelherniation and perforation as a late presentation of traumatic diaphragmatic hernia during pregnancy: a case report,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12706.