Post-supradrenalectomy diaphragmatic hernia with colonic occlusion: A laparoscopic repair

Ramon Vilallonga, PhD, Enric Caubet, PhD, Oscar Gonzalez, PhD, Jose Manuel Fort, PhD, Manuel Armengol. Universitary Hospital Vall d’Hebron. Barcelona.


Background: The diaphragmatic hernia is defined as the passage of visceral structures through a defect in the diaphragm wall. The acquired, may be secondary to penetrating abdominal trauma or iatrogenic causes after surgery.

Method: We report a case of a man of 61 years who underwent a left supradrenalectomy in 2009. During surgery, we did not document the accidental opening of the diaphragm. In March 2011, the patient came at the emergency clinic with solid dysphagia, dyspnea and abdominal pain. A CT scan showed a left diaphragmatic hernia with intrathoracic colon with partial occlusion.
A totally laparoscopic reduction and repair of the thoracic hernia was performed. A view to the chest is shown and also the placement of the thoracic drain. A complete suture of the diaphragm was performed. Laparoscopy can be considered a safe surgical technique when it comes to assess diaphragmatic hernias.

Conclusions: The diaphragmatic hernia secondary to iatrogenic disease is still quite unknown, difficult to diagnose in the absence of specific symptoms. Based on our case and after a review of the literature, laparoscopy can replace the conventional way as a standard surgical technique.

Session Number: VidTV1 – Video Channel Rotation Day 1
Program Number: V078

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