Diaphragm hernia after debulking surgery in patients with ovarian cancer

Ehmann, Sarah; Aviki, Emeline; Sonoda, Yukio; Boerner, Thomas; Sassine, Dib; Jones, David R.; Park, Bernard J.; Cohen, Murray; Rosenblum, Norman G.; Dennis, S.

doi:10.1016/j.gore.2021.100759

Cited by 3 publications

(15 citation statements)

References 16 publications

(5 reference statements)

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“…Some of the reported cases of iatrogenic diaphragmatic hernias after debulking surgery have also been associated with hypothermic intraperitoneal chemotherapy (HIPEC) [6][7][8]; it was proposed that the cytotoxic effect of intraperitoneal chemotherapy and the upgrading of abdominal pressure during HIPEC can stretch the diaphragm resulting in the development of a hernia. Our patient, in line with other recently reported cases, was submitted to a left diaphragm peritonectomy but did not receive HIPEC [5].…”

Section: Discussionsupporting

confidence: 89%

“…A delayed diaphragmatic hernia is a rare complication after cytoreduction surgery, and very few cases have been reported in the literature [5][6][7][8]. Left-sided diaphragmatic hernia is more frequent as the liver protects the right hemidiaphragm.…”

Section: Discussionmentioning

confidence: 99%

“…Resection of peritoneum and muscle tissue during diaphragm peritonectomy leads to thinning of the diaphragm and predisposes to diaphragmatic defects. Additionally, iatrogenic diaphragmatic injury during the surgery (such as thermal injury with electrocautery and accidental perforation with surgical instruments) and diaphragmatic ischemia due to peritonectomy might play a role in increasing diaphragmatic vulnerability [5,9]. Some of the reported cases of iatrogenic diaphragmatic hernias after debulking surgery have also been associated with hypothermic intraperitoneal chemotherapy (HIPEC) [6][7][8]; it was proposed that the cytotoxic effect of intraperitoneal chemotherapy and the upgrading of abdominal pressure during HIPEC can stretch the diaphragm resulting in the development of a hernia.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The most frequent complications associated with diaphragmatic peritonectomy comprise pleural effusion, pneumothorax, and pneumonia [ 4 ]. However, herniation of the abdominal contents through the diaphragm into the thoracic cavity is an uncommon but potentially fatal complication of this procedure [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Passing Through a Hole: Delayed Diaphragmatic Hernia After Cytoreductive Surgery

Mestre¹,

Simões²,

Marino³

et al. 2021

Cureus

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A diaphragmatic hernia is a protrusion of abdominal contents into the thoracic cavity. Although it is commonly congenital, diaphragmatic hernias can also be acquired. Blunt or penetrating trauma are among the most frequent causes, although spontaneous or iatrogenic cases have been reported. Recently, some case reports related to diaphragmatic hernia after debulking surgery for advanced ovarian cancer have been described. This is an exceedingly rare but life-threatening complication, being prompt recognition and surgical correction critical.We report a case of a delayed diaphragmatic hernia in a 19-year-old female resulting from cytoreductive surgery for advanced ovarian cancer. Rapid evolution from gastrointestinal symptoms to hypovolemic shock occurred, and intensive care admission was required. Immediate surgery was critical to improving the patient outcome. This case highlights this uncommon but life-threatening complication, the challenges of diagnosing and managing those patients, and the need for early recognition, support, and surgical correction.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Passing Through a Hole: Delayed Diaphragmatic Hernia After Cytoreductive Surgery

Mestre¹,

Simões²,

Marino³

et al. 2021

Cureus

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Gastric Volvulus: A Delayed Surgical Complication After Debulking and Hyperthermic Intraperitoneal Chemotherapy for Advanced Ovarian Cancer

et al. 2023

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Gastric volvulus in conjunction with diaphragmatic hernia is an uncommon but life-threatening presentation that is generally in association with hiatal hernia or diaphragmatic injuries. Diaphragmatic hernia with gastric volvulus can occur many years after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy despite initial diaphragm intactness, and should be suspected in this patient population when they present with upper gastrointestinal obstruction. An acute episode of gastric volvulus can have a mortality of 30% to 50%, hence the importance of early diagnosis and treatment. Surgical management remains the treatment of choice and can be an emergency in obstructive cases. We report the case of a 68-year-old woman presenting with signs and symptoms of acute upper gastrointestinal obstruction. Three years ago, the patient had undergone debulking surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis secondary to advanced ovarian cancer. A diagnosis of gastric volvulus was established. The pylorus was seen near the cardia on gastroscopy, and barium swallow showed stomach upside down and with a mirror image of normal anatomy suggestive of gastric volvulus. We opted for urgent laparotomy that revealed the presence of a rotated stomach adherent to the spleen and left diaphragm. After reduction, a diaphragmatic defect that was missed on the computed tomography scan was discovered and repaired, and the patient recovered uneventfully.

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Laparoscopic treatment of adult diaphragmatic hernia after minimally invasive hepatectomy: A case report and literature review

Kuzmova,

Goussens,

Dili

et al. 2023

Open J Clin Med Case Rep

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Introduction: History of surgery is the second most common cause of acquired diaphragmatic hernia (DH) after trauma. Herein, we present a case of diaphragmatic hernia following minimally invasive laparoscopic liver surgery. We also reviewed the literature on adult DH after hepatectomy, the primary surgical cause. Methods: Clinical case presentation and systematic literature review of adult DH after hepatectomy. Results: A 71-year-old male patient was diagnosed a DH 42 months after a right extended laparoscopic hepatectomy for alveolar echinococcosis. A minimal invasive approach permitted a primary suture with intraperitoneal onlay mesh. There is no sign of recurrence at the 19-months follow-up.

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Diaphragm hernia after debulking surgery in patients with ovarian cancer

Cited by 3 publications

References 16 publications

Passing Through a Hole: Delayed Diaphragmatic Hernia After Cytoreductive Surgery

Passing Through a Hole: Delayed Diaphragmatic Hernia After Cytoreductive Surgery

Gastric Volvulus: A Delayed Surgical Complication After Debulking and Hyperthermic Intraperitoneal Chemotherapy for Advanced Ovarian Cancer

Laparoscopic treatment of adult diaphragmatic hernia after minimally invasive hepatectomy: A case report and literature review

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