Ischaemic bowel within the thoracic cavity—An unusual cause of a pleural effusion

Summary 

Diaphragmatic defects are a rare complication following thoracic or upper gastro-intestinal surgery. We present a case of a 78-year-old man who presented with ischaemic bowel that had herniated through such a diaphragmatic defect, 7 years after an oesophagogastrectomy for carcinoma. The patient was taken for an immediate laparatomy for resection of the infarcted bowel, and thereafter made an uneventful recovery. Patients found to have diaphragmatic defects should be considered for surgical repair to prevent this potentially life-threatening complication.

Keywords: Metabolic acidosis, Pleural effusion, Ischaemic bowel, Diaphragmatic defect