2024 Volume 49 Issue 2 Pages 47-52
A 67-year-old woman underwent robot-assisted low anterior resection for rectal cancer and laparoscopic left lateral segmentectomy for metastatic liver tumor 2 years 7 months ago. She was referred to our hospital on account of abdominal pain and vomiting. Contrast-enhanced CT revealed a prolapse of the fornix into the left thoracic cavity with poor contrast enhancement. We made the diagnosis of a diaphragmatic hernia and performed laparoscopic hernia repair. The size of the hernia orifice was approximately 2.0 cm in diameter, and the prolapsed fornix was found to be irreversibly ischemic. We performed laparoscopic total gastrectomy, and the defect in the diaphragm was sutured. We suggest that early surgical intervention should be performed for iatrogenic diaphragmatic hernia with prolapsed bowel because of possible fatality. It is an important complication after laparoscopic hepatectomy that will increase in the future with the spread of minimal invasive surgery.
