2021 Volume 41 Issue 1 Pages 93-97
A 77-year-old man was transported to our hospital complaining of left precordial pain after falling from a ladder. He was admitted to our emergency department with the diagnosis of traumatic left hemopneumothorax and a left rib fracture, and a left thoracostomy was performed. Five days after the injury, a chest X-ray and CT showed traumatic diaphragmatic hernia, and laparoscopic surgery was performed immediately, on the same day. Intraperitoneal exploration revealed no other organ damage and the greater omentum was found to have prolapsed into the pleural cavity via the traumatic diaphragmatic defect. The greater omentum was returned into the peritoneal cavity. The defect in the diaphragm measured 40 × 40 mm in size, and was repaired using non-absorbable sutures. A repeat abdominal CT performed 5 days postoperatively revealed no evidence of hernia recurrence. The surgical approaches for traumatic diaphragmatic hernia can be divided into transthoracic and transabdominal approaches, and the laparoscopic approach is often adopted for the latter. We successfully performed laparoscopic surgery and reviewed the relevant literature, with a focus on the repair methods and port positions.
