Abstract
BackgroundDiaphragmatic hernias (DH) are generally classified as either congenital or acquired. Acquired DH are generally of traumatic cause, being a rare complication after hepatectomy. Although repair of a DH can be performed via laparotomy, laparoscopy, or thoracoscopy, the use of laparoscopy is rare after hepatectomy owing to the formation of scar tissue. In this case, we describe our successful attempt at laparoscopic repair of a recurrent DH after hepatectomy.Case presentationA 30-year-old man underwent right hepatectomy for trauma and thoracotomy via the eighth intercostal space, with direct closure of the diaphragm by suturing. The patient subsequently developed a right DH, with strangulation ileus of the small intestine. He underwent laparotomy 3 months after the initial surgery. The defect was observed to be clearly separate from the previously sutured area of the diaphragm. Five years after treatment, the patient developed abdominal pain and vomiting due to incarceration of the transverse colon in the right intrathoracic space (detected via abdominal computed tomography and radiography). The patient was again diagnosed with DH and underwent laparoscopic repair of the hernia with direct closure. The patient was discharged 11 days after surgery without further complication.ConclusionsA laparoscopic approach was feasibly and safely used to repair a recurrent DH after hepatectomy. The surgical approach will need to be decided in a patient-specific manner.
Highlights
Diaphragmatic hernias (DH) are generally classified as either congenital or acquired
Acquired DHs are generally caused by trauma with the majority occurring on the left side [1], since the anatomical location of the liver minimizes the possibility of a right-sided hernia
Laparoscopic surgery has become a widely accepted technique, including for DH repair, a laparoscopic approach is usually not considered for repair of a recurrent DH after right hepatectomy because of the dense abdominal adhesion formation
Summary
Diaphragmatic hernias (DH) are generally classified as either congenital or acquired. Laparoscopic surgery has become a widely accepted technique, including for DH repair, a laparoscopic approach is usually not considered for repair of a recurrent DH after right hepatectomy because of the dense abdominal adhesion formation. We report on our successful laparoscopic repair of a recurrent DH that developed 5 years after right hepatectomy.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
