The role of laparoscopy in the diagnosis and treatment of missed diaphragmatic rupture

Matz, A.; Landau, Ofer; Alis, Meryem Guler; Charuzi, I; Kyzer, S

doi:10.1007/s004640000112

Cited by 37 publications

(9 citation statements)

References 9 publications

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“…The short hospitalization with fewer complications makes laparoscopy also more cost efficient. Our data support the existing evidence [12,15,19] for the current major role of laparoscopy in penetrating abdominal trauma, particularly in evaluating injuries to the diaphragm and thus avoiding unnecessary laparotomy. Laparoscopy can also be used to stop bleeding from injured blood vessels or solid organs, but the danger of missing a potentially lethal injury such as small-bowel perforation still prohibits its wide usage in the treatment of penetrating injury [3,10,20].…”

Section: Discussionsupporting

confidence: 91%

Diagnostic laparoscopy for penetrating injuries in the thoracoabdominal region

et al. 2004

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Section: Discussionsupporting

confidence: 91%

Diagnostic laparoscopy for penetrating injuries in the thoracoabdominal region

et al. 2004

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“…4,10 Laparoscopic repair of traumatic diaphragmatic hernias has also been described. 11,12 The herniation of abdominal contents through the esophageal hiatus normally involves trans-thoracic displacement of the stomach. The portion of herniated stomach can range from only the gastroesophageal junction to the entire stomach.…”

Section: Discussionmentioning

confidence: 99%

Isolated Trans-hiatal Colonic Herniation

Felsher

Brodsky

Brody

2003

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Isolated herniation of the colon through congenital or traumatic diaphragmatic defects are well documented. However, trans-hiatal herniation of the colon in the absence of an intrathoracic stomach has been reported only once. A 67-year-old man presented with intragastric abdominal pain and a chest x-ray film documenting a posterior mediastinal air-fluid level. Computed tomography showed gastrointestinal contents within the thorax. The findings on an upper gastrointestinal film with small bowel follow-through were normal. Finally, a barium enema identified transverse colon within the thoracic cavity. At laparoscopy, the entire transverse colon was reduced with the hernia sac. The crural defect was repaired, and a Toupet fundoplication was performed. A gastropexy was also added. The patient was discharged on postoperative day 2 able to tolerate a regular diet, and he has been asymptomatic for 5 months. This defect most likely represents a congenital deformity of the diaphragm with intact posterior gastric attachments, including the posterior phrenoesophageal ligament. An intact gastric mesentery enabled isolated colonic herniation with retention of the stomach its normal anatomic position. An antireflux procedure was performed in addition to the crural repair because of the circumferential dissection of the esophagus. This article is the second report of an isolated trans-hiatal herniation of the colon and the first report of laparoscopic repair of this entity.

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“…CT can be useful in visualizing defects with protruding viscera [34]. If the index of suspicion is high for a diaphragmatic injury, normal radiological studies should not deter laparoscopy or surgical exploration of the diaphragm [35]. All diaphragmatic hernias should be fixed on diagnosis to avoid strangulation or acute respiratory distress.…”

Section: Diaphragmatic Herniasmentioning

confidence: 99%

Abdominal Cavity: Anatomy, Structural Anomalies, and Hernias

Parangi¹,

Hodin²

2008

Textbook of Gastroenterology

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During embryonic development, the foregut rotates 90°c lockwise around its longitudinal axis, causing the left side of the stomach to face anteriorly and its right side posteriorly ( Fig. 98.1). The foregut blood supply is the celiac artery.The development of the midgut is characterized by rapid elongation of the gut and its mesentery, resulting in the formation of the primary intestinal loop. Over its entire length, the midgut is supplied by the superior mesenteric artery. As a result of this rapid elongation and the simultaneous expansion of the liver, the abdominal cavity of the fetus becomes too small to contain all the intestinal loops. These loops enter the extraembryonic coelomic cavity in the umbilical cord, forming a physiological umbilical herniation during the sixth week of development ( Fig. 98.2). Coincident with this rapid growth, the midgut rotates 270°counterclockwise around the axis of the superior mesenteric artery. At about the third month, the herniated intestinal loops return to the abdominal cavity. The proximal portion of the jejunum is the first part to reenter, and it comes to lie on the left side, whereas the primitive cecum is the last to reenter and descends into the right iliac fossa.The hindgut gives rise to colon and rectum past the distal third of the transverse colon as well as the upper part of the anal canal. The junction of the endodermal and ectodermal parts of the anal canal is formed by the pectinate line, which is found just below the anal columns. The endoderm of the hindgut also gives rise to the internal lining of the bladder and urethra. The hindgut blood supply is the inferior mesenteric artery. Mesenteries of the abdominal cavityDuring the development of the peritoneal cavity, the splanchnic mesoderm covers the developing gut. Eventually, most of this ventral mesentery is resorbed, except for a small portion between the liver and the stomach that persists as the Embryology of the abdominal cavity Abdominal cavityKnowledge of the embryology of the abdominal contents is imperative to understanding the pathophysiology of the various congenital and structural anomalies of the abdominal cavity. The abdominal or peritoneal cavity is formed from a large intraembryonic coelomic cavity during the fourth week of embryonic development. The cells of the somatic mesoderm lining the intraembryonic coelomic cavity become mesothelial and form the parietal layer of the serous membranes lining the outside of the peritoneal, pleural, and pericardial cavities. In a similar manner, the cells of the splanchnic mesoderm layer form the visceral layer of the serous membranes covering the abdominal organs, lungs, and heart [1]. During the fifth to seventh weeks of development, the pleuroperitoneal folds fuse with the septum transversum, and the mesentery of the esophagus thus separates the thoracic cavity from the abdominal cavity. In the cephalic and caudal parts of the embryo, the primitive gut (an endodermal-lined cavity) forms a blind-ending tube, the foregut and the hindgut, respectively....

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The role of laparoscopy in the diagnosis and treatment of missed diaphragmatic rupture

Abstract: Laparoscopy has an important role in the surgical treatment of missed diaphragmatic ruptures.

Cited by 37 publications

References 9 publications

Diagnostic laparoscopy for penetrating injuries in the thoracoabdominal region

Diagnostic laparoscopy for penetrating injuries in the thoracoabdominal region

Isolated Trans-hiatal Colonic Herniation

Abdominal Cavity: Anatomy, Structural Anomalies, and Hernias

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