Repair of Chronic Post-traumatic Diaphragmatic Hernia by Laparoscopic Surgery
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.
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