The role of laparoscopy in the diagnosis and treatment of missed diaphragmatic rupture

Background: Diaphragmatic rupture is one of the most commonly missed injuries in trauma cases. Traditionally, laparotomy or thoracotomy has been the treatment of choice for this condition. Methods: During the last 2 years, we treated three patients laparoscopically to address neglected diaphragmatic ruptures that caused herniation of the intraabdominal contents. Results: In all three cases, laparoscopy succeeded in identifying the diaphragmatic defect, so that the herniated viscera could be released and the defect repaired primarily or with a prosthesis. The intraoperative and the postoperative courses were uneventful; there were no significant complications. Conclusion: Laparoscopy has an important role in the surgical treatment of missed diaphragmatic ruptures. Received: 12 July 1999/Accepted: 21 October 1999/Online publication: 8 May 2000