2022 Volume 42 Issue 1 Pages 101-104
The patient was a 63-year-old woman, in whom we had performed laparoscopic hepatic cyst deroofing 6 months earlier for a 18-cm hepatic cyst in the lateral segment of the liver; after fenestration and suction of fluid, we had resected the cyst wall which was adherent to the left diaphragm. She presented to us 6 months after the surgery, complaining of diarrhea and fever. We made the diagnosis of pseudomembranous enteritis and admitted her to the gastrointestinal surgery department of our hospital, but she began to complain of nausea and vomiting. On the 4th day of hospitalization, CT showed rupture of the left diaphragm, with most of the stomach lying in the left thoracic cavity, and we diagnosed diaphragmatic hernia. On the same day, we performed emergent laparotomy and repaired the diaphragmatic hernia. The hernia orifice measured 3 cm in diameter. We pulled the stomach back into the abdominal cavity, and closed the hernia defect in the diaphragm by direct closure. Although delayed diaphragmatic hernia after laparoscopic hepatic cyst deroofing for a liver cyst is rare, careful observation bearing the possibility of delayed occurrence of diaphragmatic hernia in mind is necessary.
