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Laparoscopic repair of traumatic diaphragmatic hernia with colon incarceration: A case report
Authors:Saki Nishikawa  Masashi Miguchi  Hideki Nakahara  Takashi Urushihara  Hiroyuki Egi  Daiki Shorin  Hideki Fukuda  Toshiyuki Itamoto
Institution:1. Department of Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan;2. Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;3. Department of Anesthesiology, Hiroshima Prefectural Hospital, Hiroshima, Japan;4. Department of Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan

Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

Abstract:Traumatic diaphragmatic hernia is a serious complication of blunt trauma to the abdomen or thorax. Although traumatic diaphragmatic hernia is treated with surgical repair, a laparoscopic approach is infrequently employed. Here we present the case of a 66-year-old man with a bruise on the left side of his back. CT revealed a left pneumothorax and left rib fractures. He was urgently hospitalized and relieved with conservative treatment. However, on day 4 of hospitalization, an incarcerated diaphragmatic hernia containing the transverse colon was observed on CT. The herniated viscera of the abdominal cavity were reduced laparoscopically, and the hernial orifice was repaired with direct closure. One-lung ventilation was used to limit the movement of the affected diaphragm, enabling effective laparoscopic suturing. The patient had an uneventful recovery period and was discharged 8 days postoperatively. The absence of diaphragmatic herniation recurrence was confirmed 6 months after surgery.
Keywords:laparoscopic surgery  one-lung ventilation  traumatic diaphragmatic hernia
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