Asian J Endosc Surg

. 2022 Apr;15(2):388-392. doi: 10.1111/ases.13015. Epub 2022 Feb 7. https://pubmed.ncbi.nlm.nih.gov/35132800/

Delayed presentation of a post-traumatic large right diaphragmatic hernia displacing liver and gallbladder – A case report

Nikunj Jain ¹, Bhanu Prakash Raju ¹, Sourabh Dhanda ¹, Vishwas Johri ¹, Prasanna Kumar Reddy ¹, Jainudeen Khalander Abdul Jameel ¹Affiliations expand

• PMID: 35132800
• DOI: 10.1111/ases.13015

Abstract

Blunt or penetrating trauma resulting in injury or rupture of the diaphragm is rare and constitutes about 1% to 3.9% of all thoraco-abdominal injuries. It is often regarded as a marker of severe trauma. Unfortunately about half of these injuries can be missed during the index admission. Contrast-enhanced computed tomography is the best modality to assess the extent, size of diaphragmatic defect and nature of hernial contents. Surgery is mandatory once the diagnosis is made to prevent future strangulation of hernial contents. Although technically challenging, laparoscopic reduction and mesh repair is feasible in expert hands. We report our experience with laparoscopic repair and mesh re-enforcement in a patient who had a large right diaphragmatic hernia with part of liver, gallbladder, small bowel and omentum within the right hemithorax secondary to a penetrating trauma he had incurred 29 years earlier.

Keywords: hepatothorax; intrathoracic gallbladder; traumatic diaphragmatic hernia.

© 2022 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.