Unusual delayed presentation of post-traumatic intrapericardial hernia associated with intestinal occlusion

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Alessandro Bini
Fabio Davoli
Nicola Cassanelli
Giampiero Dolci
Giulia Luciano
Franco Stella


AIM: We report a case of a 64-year-old man, admitted to our department following the onset a few months earlier of canalization disorders and a sensation of retrosternal tension.

MATERIAL OF STUDY: Patient’s history revealed blunt thoraco-abdominal trauma with multiple costal fractures 15 years earlier as a result of a road accident and a cholecystectomy at the age of 57. A barium meal revealed an intrapericardial displacement of some intestinal loops; as the patient suffered acute intestinal occlusion with severe abdominal pain associated with nausea and vomiting, we performed an emergency median xipho-umbilical laparotomy, making it possible to identify both the site of the retrosternal diaphragmatic laceration with intrapericardial colonic herniation and the true cause of the occlusion: an adhesion, caused by the previous cholecistectomy, which was strangulating a jejunal loop. After detaching the adhesion between the colon and the pericardium, the viscera were replaced in the abdominal cavity and the diaphragmatic opening was closed.

RESULTS: The post-operative period was uneventful; a barium enema demonstrated the abdominal dislocation of the viscera. No recurrence was detected during the 48 months of follow-up.

CONCLUSIONS: A rare pathological event, such as an intrapericardial diaphragmatic hernia, was combined with intestinal occlusion, initially attributed to a further complication of the hernia itself, but in actual fact independent of the hernia and a consequence of a previous cholecystectomy.

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How to Cite
Bini, Alessandro, et al. “Unusual Delayed Presentation of Post-Traumatic Intrapericardial Hernia Associated With Intestinal Occlusion”. Annali Italiani Di Chirurgia, vol. 81, no. 1, Jan. 2010, pp. 45-47, https://annaliitalianidichirurgia.it/index.php/aic/article/view/2767.
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