Laparoscopic Repair of Acute Traumatic Diaphragmatic Hernia: A Case Report

Cureus · 5 authors, 5 centres

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TL;DR

This case report describes the successful laparoscopic repair of an acute traumatic diaphragmatic hernia in a young patient following blunt thoracoabdominal injury, highlighting the feasibility and efficacy of this minimally invasive surgical approach.

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This is a case report detailing the management of an acute traumatic diaphragmatic hernia in a young patient who presented with unexplained dyspnea after blunt thoracoabdominal injury. Imaging confirmed herniation of abdominal organs into the left hemithorax. Laparoscopic exploration revealed a left hemi-diaphragmatic tear with herniation of the transverse colon, omentum, small bowel, and stomach. The surgical intervention consisted of laparoscopic reduction of the herniated organs and tension-free primary closure with gastropexy, without mesh reinforcement. The patient had an uneventful postoperative recovery. The report demonstrates the feasibility of laparoscopic repair for this acute condition, consistent with limited existing literature, but notes that the approach is best suited for hemodynamically stable patients. Limitations include the single-case design, precluding generalizable conclusions about long-term outcomes or comparative effectiveness.

STUDY TYPE

case_report

SPECIALTY

surgery

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AI pipeline

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100% · A

ORIGINAL PAPER

PMC10369083

Laparoscopic Repair of Acute Traumatic Diaphragmatic Hernia: A Case Report

Cureus

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ABSTRACT

Traumatic diaphragmatic hernia (TDH) is a rare condition resulting from blunt or penetrating thoracoabdominal trauma and is characterized by the protrusion of abdominal organs into the thoracic cavity through a ruptured diaphragm. Due to its diverse clinical presentations, TDH often faces diagnostic challenges. Accurate diagnosis relies on imaging studies and surgical exploration, with surgical intervention being the primary treatment approach. This case presentation highlights a young patient who presented to Saint George Hospital following a blunt thoracoabdominal injury. The patient experienced unexplained dyspnea upon admission, and imaging revealed herniated bowels in the left hemithorax. Laparoscopic exploration confirmed a left hemi-diaphragmatic tear, with the transverse colon, omentum, most of the small bowel, and stomach herniating into the left hemithorax. The patient underwent laparoscopic repair, involving the reduction of the herniated organs into the peritoneal cavity and tension-free primary closure with gastropexy without the use of mesh for reinforcement. The patient’s postoperative course was uneventful, and complete recovery was achieved. This case report provides insights into the diagnosis and management of TDH, highlighting the importance of prompt recognition and appropriate surgical intervention in achieving successful outcomes.

CITATION EXPORT

Rim H Charara, Rana Ibrahim, Rana Zaarour et al.. Laparoscopic Repair of Acute Traumatic Diaphragmatic Hernia: A Case Report. Cureus. (2023). https://doi.org/10.7759/cureus.40959

AUTHORS

5 · 5 CENTRES

Rim H Charara, Rana Ibrahim, Rana Zaarour, Ali Houmani, Houssein Haidar Ahmad

1 Internal Medicine, Lebanese University Faculty of Medicine, Beirut, LBN
2 Research Department, Saint George Hospital, Beirut, LBN
3 Pulmonary and Critical Care Department, Saint George Hospital, Beirut, LBN
4 Radiology Department, Saint George Hospital, Beirut, LBN
5 Surgery Department, Saint George Hospital, Beirut, LBN

EDITOR / REVIEWER

Alexander Muacevic, John R Adler