A case of traumatic diaphragmatic hernia accompanied by rupture of the pericardium requiring thoracic and abdominal surgery

Abstract

A 78-year-old man was injured in a traffic accident and was admitted to our hospital. Thoraco-abdominal CT showed the stomach and the transverse colon in the left thoracic cavity. Under a diagnosis of diaphragmatic hernia, an emergency operation was performed. A thoracotomy was made at the 7^th intercostasl space with the patient in a right semi lateral position. A torn left diaphragm was found along with the herniated stomach and the transverse colon. After the abdominal organs were reduced back into the abdominal cavity, the diaphragmatic fissure was found to reach the pericardium. The torn pericardium was repaired with a PTFE patch from the abdominal side. Patients with a traumatic diaphragmatic hernia must be positioned for surgery in such a manner that allows an abdominal approach and thoracic approach.