C Diven1, R Latifi2,3. 1. Division of Trauma, Critical Care and Emergency Surgery, Department of Surgery, University of Arizona, 1501 N. Campbell Avenue, Tucson, AZ, 85724, USA. 2. Division of Trauma, Critical Care and Emergency Surgery, Department of Surgery, University of Arizona, 1501 N. Campbell Avenue, Tucson, AZ, 85724, USA. Latifi@surgery.arizona.edu. 3. Trauma Services, Hamad Medical Corporation, Doha, Qatar. Latifi@surgery.arizona.edu.
Abstract
INTRODUCTION: Traumatic diaphragmatic rupture is a relatively uncommon occurrence, with an incidence of 0.8-5% reported in the literature. The reported percentage of missed diaphragmatic injuries that were discovered later ranges from 12 to 66%. Herniation of the liver through the right diaphragm has been reported in the literature after liver transplantation, and in trauma populations. MATERIALS AND METHODS: Here, we report a case of late identification of partial liver herniation into the right chest (8 years post initial injury), due to a recent motor vehicle crash. Thought to be suffering from an acute injury, the patient was taken to the operating room and a laparoscopically assisted mini-thoracotomy was performed. An old diaphragmatic injury was found intraoperatively; laparoscopically assisted mini-thoracotomy was used to repair the diaphragm, and the liver was returned into the abdomen. CONCLUSION: Right-sided diaphragmatic laceration, if diagnosed at the time of injury, may be repaired with the minimally invasive technique we describe here.
INTRODUCTION:Traumatic diaphragmatic rupture is a relatively uncommon occurrence, with an incidence of 0.8-5% reported in the literature. The reported percentage of missed diaphragmatic injuries that were discovered later ranges from 12 to 66%. Herniation of the liver through the right diaphragm has been reported in the literature after liver transplantation, and in trauma populations. MATERIALS AND METHODS: Here, we report a case of late identification of partial liver herniation into the right chest (8 years post initial injury), due to a recent motor vehicle crash. Thought to be suffering from an acute injury, the patient was taken to the operating room and a laparoscopically assisted mini-thoracotomy was performed. An old diaphragmatic injury was found intraoperatively; laparoscopically assisted mini-thoracotomy was used to repair the diaphragm, and the liver was returned into the abdomen. CONCLUSION: Right-sided diaphragmatic laceration, if diagnosed at the time of injury, may be repaired with the minimally invasive technique we describe here.
Authors: Benjamin S Powell; Louis J Magnotti; Thomas J Schroeppel; Christopher W Finnell; Stephanie A Savage; Peter E Fischer; Timothy C Fabian; Martin A Croce Journal: Injury Date: 2008-03-11 Impact factor: 2.586