Left Trans-thoracic Evisceration of a Perforated Transverse Colon

Abstract

We received a 31 years old male who presented to the emergency after been stabbed on both thorax. The left thoracic wound was the site of evisceration of colon. The  eviscerated colon was perforated. The patient was instable. After stabilisation, he was operated under general anesthesia. A bilateral thoracic drainage done,one and the right thoracic stab wound was then closed. A median laparotomy discovered the left colic herniation through the left diaphragmatic coupole, continuing through the thorax by the evisceration and a gastric tear. The colon was wached and reduced first through the abdomen by gentle traction. The left parietal wound was then closed. The left thorax cavity was washed and the diaphragmatic hole closed. The left transverse colonic tear was excised and closed. He stayed 5 days in the   intensive care unit. We had a superficial site infection of the laparotomy wound treated by saline wet dressing for 20 days. After one month hospitalisation, the patient was discharged. He resumed his work after 3 months and is doing well at 12 months postoperative. This case emphasizes on a rare surprise awaiting the trauma surgeon.