Delayed presentation of post-traumatic diaphragm rupture repaired by laparoscopy

Houston, James; Jalil, Rozh; Isla, Alberto

doi:10.1136/bcr-2012-007372

Cited by 7 publications

(2 citation statements)

References 10 publications

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“…Laparoscopic repair is recommended for noncomplicated presentation of PTDH. 9 The advantages are shorter hospital stay, smaller incision, reduced pain and blood loss. In the presence of even a small amount of contamination, we should go for conversion to open laparotomy.…”

Section: Discussionmentioning

confidence: 99%

Colonic perforation secondary to post traumatic diaphragmatic hernia: a case report

Rawat

Dharampaul

Bhatia³

et al. 2023

Int J Res Med Sci

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Post traumatic diaphragmatic hernia (PTDH) is a rare cause of large bowel obstruction, and can present weeks or years after the initial trauma. We report the case of a 42 years old male adult who presented in emergency with features of acute generalised peritonitis secondary to closed loop obstruction. Patient had history of fall leading to blunt trauma chest 9 months back which was managed with Intercostal drainage (ICD) left chest at that time. Chest radiography showed multiple air-fluid levels in the left upper quadrant, an air-fluid level in the left thoracic cavity and significant free air under the right side of diaphragm. On laparotomy there was feculent material in abdominal cavity, dilated caecum, ascending colon, transverse colon with invagination of splenic flexure of colon into thoracic cavity. A segment of transverse colon was gangrenous and there was a perforation of size 2 x 2 cm present. Right hemicolectomy performed and loop ileostomy along with DMF transverse colon fashioned in emergency setting. Diaphragmatic hernia repaired after 3 months. Posttraumatic diaphragmatic hernias should be part of the differential diagnosis for patients with bowel obstruction, especially if there is a history of trauma. Radiography is useful in facilitating a quick diagnosis. When patients present complications, there is a higher rate of morbidity and mortality (31%) therefore emergency surgery is mandatory.

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Section: Discussionmentioning

confidence: 99%

Colonic perforation secondary to post traumatic diaphragmatic hernia: a case report

Rawat

Dharampaul

Bhatia³

et al. 2023

Int J Res Med Sci

View full text Add to dashboard Cite

show abstract

“…However, open surgical procedures are associated with increased postoperative pain, increased hospital length of stay, and development of long-term complications, such as an incisional hernia [ 9 , 10 ]. In comparison, laparoscopy offers the benefits of less postoperative pain (and thus less dependence on analgesics), faster recovery, and a decreased risk of wound complications [ 2 , 11 ]. Nonetheless, in both open and minimally invasive surgical procedures, the use of mesh is necessary when the edges cannot be approximated tension-free [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Repair of Diaphragmatic Rupture: A Case Report with Radiological and Surgical Correlation

Nguyen

Davis

Tran

2017

Case Reports in Surgery

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The leading cause of diaphragmatic rupture is penetrating abdominal trauma, including gunshot- and stab-related wounds; however, diaphragmatic rupture can also result from blunt trauma to the abdomen. The diagnosis can be difficult to make as the physical examination may be unremarkable, and imaging, that is, a conventional chest X-ray and/or CT imaging, may initially fail to reveal the injury. Failure to recognize diaphragmatic rupture can result in a delayed presentation, sometimes years later, with a potential catastrophic outcome. Therefore, prompt and swift diagnosis is critical to avoid this potential harmful scenario. Traditionally, repair is performed through a laparotomy or a thoracotomy incision. Owing to the many advances made in minimally invasive surgery, not only has laparoscopy become the modality of choice to diagnose diaphragmatic rupture due to its high degree of sensitivity and specificity, but it can provide simultaneous therapeutic intervention as well. We report a case of laparoscopic repair of a diaphragmatic rupture in a 22-year-old female who sustained blunt abdominal trauma during a motor vehicle accident.

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Complicated Diaphragmatic Hernia in Emergency Surgery: Systematic Review of the Literature

et al. 2020

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Introduction Complicated diaphragmatic hernia (DH) can be congenital or acquired. Congenital diaphragmatic hernias (CDH) are rare and often can be asymptomatic until adulthood. Traumatic diaphragmatic hernia (TDH) is a complication that occurs in about 1–5% of victims of road accidents and in 10–15% of penetrating traumas of the lower chest. CDH and TDH are potentially life‐threatening conditions, and the management in emergency setting still debated. This study aims to evaluate the surgical treatment options in emergency setting. Methods A bibliographic research reporting the item “emergency surgery” linked with “traumatic diaphragmatic rupture” and “congenital diaphragmatic hernia” was performed. Several parameters were recorded including sex, age, etiology, diagnosis, treatment, site and herniated organs. Results The research included 146 articles, and 1542 patients were analyzed. Most of the complicated diaphragmatic hernias occurred for a diaphragmatic defect due to trauma, only 7.2% occurred for a congenital diaphragmatic defect. The main diagnostic method used was chest X‐ray and CT scan. Laparotomic approach still remains predominant compared to the minimally invasive approach. Conclusion Surgery is the treatment of choice and is strongly influenced by the preoperative setting, performed mainly with X‐ray and CT scan. Minimally invasive approach is safe and feasible but is highly dependent on the surgeon's expertise, especially in emergency setting.

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Delayed presentation of post-traumatic diaphragm rupture repaired by laparoscopy

Cited by 7 publications

References 10 publications

Colonic perforation secondary to post traumatic diaphragmatic hernia: a case report

Colonic perforation secondary to post traumatic diaphragmatic hernia: a case report

Laparoscopic Repair of Diaphragmatic Rupture: A Case Report with Radiological and Surgical Correlation

Complicated Diaphragmatic Hernia in Emergency Surgery: Systematic Review of the Literature

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