Repair of Chronic Post-traumatic Diaphragmatic Hernia by Laparoscopic Surgery

Authors

  • Paisal Pongchairerks Department of Surgery, Ramathibodi Hospital, Rama VI Road, Bangkok 10400, Thailand

Abstract

           Traumatic ruptures of the diaphragm can be diagnosed in the acute and chronic phases after penetrating or blunt injuries. All diaphragmatic hernias must be repaired once diagnosed. At present, laparoscopic or thoracoscopic repairs can be effective in patients who are not in serious hemodynamic conditions. Two patients who developed symptoms of gastrointestinal obstruction of short duration following a blunt and a penetrating trauma 15 months and 30 years previously were reported. The herniated structures were stomach and omentum in one patient and splenic flexure of colon and omentum in the other. Laparoscopic surgery was successful in reducing the herniated viscera, lysis of adhesion and repairing of the diaphragmatic defect using simple sutures with silk. Medium-term follow-up in one patient and long-term follow-up in the other revealed normal chest x- rays in both of them and were symptom free. Laparoscopic repair is an effective means of treatment for chronic diaphragmatic hernias.

References

1. Rusch VW, Ginsberg RJ. Chest wall, pleura, lung and mediastinum. In: Schwarrz Sl, Shires GT, Spencer FC, Daly JM, Fischer JE, Galloway. AC. Principles of Surgery, 7th edition. New York: McGraw-Hill Company. 1999: 685.

2. Ivatury RR, Simon RJ, Stahl WM. A critical evaluation of laparoscopy in penetrating abdominal trauma. J Trauma 1993:34: 822-7.

3. Frantzides CT, Carison MA. Laparoscopic repair of a penetrating injury to the diaphragm: a case report. J Laparoendosc Surg 1994; 4: 153-6.

4. Meyer G, Hutti TP, Hatz RA, Schildberg FW, Laparoscopic repair of traumatic diaphragmatic hernias. Surg Endosc 2000;14: 1010-4.

5. Domene CE, Volpe P, Santo MA, Onari P, Szachnowicz S, Pinotti Hw. Laparoscopic treatment of traumatic diaphragmatic hernia. J Laparoendosc Adv Surg Tech A 1998; 8:225-9.

6. Asaoka M, Sasaki M, Masumoto H, Kajiyama M, Seki A. A case report of traumatic diaphragmatic hernia treated by thoracoscopic surgery. Nippon Kyobu Geka Gakkai Zasshi 1995;43: 1770-3.

7. Koehler RH, Smith RS. Thoracoscopic repair of missed diaphragmatic injury in penetrating trauma: a case report. J Trauma 1994;36: 424-7.

8. Kocher TM, Gurke L, Kuhrmeier A, Martinoli S. Misleading symptoms after a minor blunt chest trauma: thoracoscopic treatment of diaphragmatic rupture. Surg Endosc 1998; 12:879-81.

9. Kurata K, Kubota K, Oasawa H, Eda N, Ishihara T. Thoracoscopic repair of traumatic diaphragmatic rupture: a case report. Surg Endosc 1996; 10: 850-1.

10. Thomas P, Moutardier V, Ragni J, Giudicelli R, Fuentes P. Video-assisted repair of a ruptured right diaphragm. Eur J Cardiothorac Surg 1994; 8: 157-9.

11. Slim K, Bousquet J, Chipponi J. Laparoscopic repair of missed blunt diaphragmatic rupture using a prosthesis. Surg Endosc 1998;12:1358-60.

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Published

2001-03-30

How to Cite

1.
Pongchairerks P. Repair of Chronic Post-traumatic Diaphragmatic Hernia by Laparoscopic Surgery. Thai J Surg [Internet]. 2001 Mar. 30 [cited 2024 Dec. 23];22(1):11-4. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/243269

Issue

Vol. 22 No. 1 (2001): January - March

Section

Case Reports

License

Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.