Transdiaphragmatic Intercostal Hernia- An Unusual Hepatic Injury After a Car Accident:  A Case Report and Review of the Literature

Ioannidis, Orestis; Mariorakis, Chrysovalantis; Malliora, Anastasia; Christidis, Panagiotis; Loutzidou, Lydia; Mantzoros, Ioannis; Mg, Pramateftakis; Kotidis, Efstathios; Ouzounidis, Nikolaos; Foutsitzis,; Aggelopoulos, S.

doi:10.15190/d.2021.2

Cited by 3 publications

(2 citation statements)

References 8 publications

(20 reference statements)

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“…Ioannidis et al reported a female having blunt abdominal trauma resulting in a right-sided diaphragmatic injury and protrusion of the right lobe of the liver in the thoracic cavity along with a fracture of the right lower ribs [ 12 ]. Other unusual presentations may include other abdominal organs in the thorax, as seen in a case report of Daha et al in which a 24-year-old female with a right thoracic kidney with Bochdalek hernia was diagnosed incidentally [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Intra-thoracic Symptomatic Gallstones in a Right-Sided Post-traumatic Diaphragmatic Hernia: A Case Report

Soomro¹,

Hassan²,

Nazir³

et al. 2022

Cureus

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Herniation of abdominal contents through the diaphragm into the thoracic cavity can occur after blunt abdominal injury, resulting in a permanently acquired diaphragmatic hernia. Their clinical presentation is varied and non-specific, which can go unnoticed for a long duration.A 27-year-old male presented with right upper quadrant pain and right-sided pleuritic chest pain for the past 20 days. His past medical history included high-impact blunt trauma a few years back. His workup revealed a right-sided diaphragmatic hernia through which the gallbladder had herniated into the thoracic cavity, along with liver and hepatic flexure of the colon. The gallbladder contained gallstones which were the cause of his symptoms. The patient was managed successfully with a laparotomy and repair of the diaphragmatic hernia and cholecystectomy.After blunt abdominal trauma, right-sided diaphragmatic injury is less common because most of the trauma is absorbed by the liver, providing a protective effect. The sign and symptoms of acquired diaphragmatic hernia lack sensitivity and specificity, due to which many cases remain undiagnosed and are incidentally picked up on chest auscultation where bowel sounds are audible in the chest, and breath sounds on the affected side are absent, whereas patients have complaints of respiratory difficulty and recurrent pneumonia. Chest and abdominal imagining in the form of chest X-rays and abdominal ultrasound can help diagnose.The case we present was a unique presentation of acquired right-sided diaphragmatic hernia resulting in herniation of the gallbladder in the right-sided chest and leading to acute cholecystitis. The treatment modality is surgical repair of the diaphragm. Any patient presenting with unusual symptoms of pneumonia or abdominal pain should be investigated, especially patients with a history of blunt abdominal trauma.

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Section: Discussionmentioning

confidence: 99%

Intra-thoracic Symptomatic Gallstones in a Right-Sided Post-traumatic Diaphragmatic Hernia: A Case Report

Soomro¹,

Hassan²,

Nazir³

et al. 2022

Cureus

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“…There are several surgical options for the treatment of TDIH including primary closure, using mesh, and closure with prosthetic or autologous material [ 9 ]. In acute state of diaphragmatic hernia, primary repair of diaphragm is reasonable.…”

Section: Correspondencementioning

confidence: 99%

Non traumatic acquired acute transdiaphragmatic intercostal hernia induced by coughing

Lee

Kim

Jeong

2023

J Cardiothorac Surg

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Transdiaphragmatic intercostal hernia is a rare disease. It is usually caused by trauma and is rarely caused by coughing. Although a few cases of intercostal hernia induced by coughing have been reported, our case of a non traumatic acquired acute transdiaphragmatic intercostal and abdominal hernia induced by coughing is very rare. A 77-year-old woman presented with sudden-onset left lower chest pain after an episode of violent coughing. She had risk factors for intercostal hernia, including obesity, chronic obstructive pulmonary disease, oral steroid use, and diabetes mellitus. Computed tomography showed herniation of the lung and intra-abdominal organs into the thoracic and abdominal wall through a ruptured diaphragm, as well as the intercostal and abdominal muscles. Surgery was completed with interrupted sutures to close the defects after the reduction of the herniated organs. Our experience suggests that careful examinations, including the assessment of risk factors and computed tomography imaging, were essential for establishing an accurate diagnosis, and that the repair of a ruptured diaphragm with simple interrupted sutures without any prosthetic materials seems to be feasible in selected patients with a transdiaphragmatic intercostal hernia.

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Approach to Acute Traumatic and Nontraumatic Diaphragmatic Abnormalities

Keyes,

Spouge,

Kennedy

et al. 2024

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Transdiaphragmatic Intercostal Hernia- An Unusual Hepatic Injury After a Car Accident: A Case Report and Review of the Literature

Cited by 3 publications

References 8 publications

Intra-thoracic Symptomatic Gallstones in a Right-Sided Post-traumatic Diaphragmatic Hernia: A Case Report

Intra-thoracic Symptomatic Gallstones in a Right-Sided Post-traumatic Diaphragmatic Hernia: A Case Report

Non traumatic acquired acute transdiaphragmatic intercostal hernia induced by coughing

Approach to Acute Traumatic and Nontraumatic Diaphragmatic Abnormalities

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