Intrathoracic Caecal Perforation Presenting as Dyspnea

Figure 2

Multidetector CT performed after contrast medium injection and reformation in the frontal plane (a) revealed a large defect in the right diaphragm with herniation of the right colon (straight arrow). Fluid present above the right diaphragm is explained by the distension and perforation of the caecum (double arrows). Note the dilatation of the small bowel loops in relationship with incarceration of the caecum through the diaphragm defect. Maximal intensity projection (MIP) performed on a posterior plane (b) revealed the migration of the right colonic artery (straight arrow) with the ascension of the right colon. Inset: intraoperative view of the right colon herniated through the Bochdalek hernia (arrow).