Laparoscopic repair of intrathoracic liver herniation after traumatic rupture of the diaphragm


Right diaphragmatic hernia after abdominal trauma is a rare injury. Most patients can be asymptomatic, and the diagnosis may be delayed for several years. The treatment of choice involves surgical repair via laparotomy. The authors treated a young patient with transdiaphragmatic herniation of the right hepatic lobe and delayed diagnosis using a laparoscopic approach and accomplished a successful complete repair. The 6-month radiologic follow-up assessment confirmed good results.

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  1. 1.

    Athanassiadi K, Kalavrouziotis G, Athanassiou M, Vernikos P, Skrekas G, Poultisi A, Bellenis I (1999) Blunt diaphragmatic rupture. Eur J Cardiothorac Surg 4:469–474

  2. 2.

    Kotoulas C, Chouliaras E, Siarapis P, Nisotakis K (2004) Right diaphragmatic rupture and hepatic hernia: a rare late sequela of thoracic trauma. Eur J Cardiothorac Surg 25:1121

  3. 3.

    Khreiss M, Karam J, Musallam KM, Al Harakeh AB, Nasr VG, Abi Saad GS (2009) Distinctive presentation of a diaphragmatic hernia 15 years after a traumatic insult. Ann Thorac Surg 88:651–653

  4. 4.

    Kaw LL, Potenza BM, Coimbra R, Hoyt DB (2004) Traumatic diaphragmatic hernia. J Am Coll Surg 198:668–669

  5. 5.

    Sirbu H, Busch T, Spillner J, Schachtrupp A, Autschbach R (2005) Late bilateral diaphragmatic rupture: challenging diagnostic and surgical repair. Hernia 9:90–92

  6. 6.

    Campos LA, Sipes EK (1991) Laparoscopic repair of diaphragmatic hernias. Surg Endosc 14:369–373

  7. 7.

    Kuster GG, Kline LE, Garzo G (1992) Diaphragmatic hernia through the foramen of Morgagni: laparoscopic repair: case report. J Laparoendosc Surg 2:93–100

  8. 8.

    Ramachandran CS, Arora V (1999) Laparoscopic transabdominal repair of hernia of Morgagni_larrey. Surg Laparosc Endosc Percutan Tech 9:358–361

  9. 9.

    Rice GD, O’Boyle CJ, Watson DI, Devitt PG (2001) Laparoscopic repair of Bochdaleck hernia in an adult. ANZ J Surg 71:443–445

  10. 10.

    Meyer G, Huttl TP, Hatz RA, Schildberg FW (2000) Laparoscopic repair of traumatic diaphragmatic hernias. Surg Endosc 14:1010–1014

  11. 11.

    Lomanto D, Poon PL, So JB, Sim EW, El Oakley R, Goh PM (2001) Thoracolaparoscopic repair of traumatic diaphragmatic rupture. Surg Endosc 15:323

  12. 12.

    Cueto J, Vasquez-Frias JA, Nevarez R, Poggi L, Zundel N (2001) Laparoscopic repair of traumatic diaphragmatic hernia. Surg Laparosc Endosc Percutan Tech 11:121–209

  13. 13.

    Smith CH, Novick TL, Jacobs DG, Thomason MH (2000) Laparoscopic repair of a ruptured diaphragm secondary to blunt trauma. Surg Endosc 14:501–502

  14. 14.

    Frantzides CT, Madan AK, O’Leary PJ, Losurdo J (2003) Laparoscopic repair of a recurrent chronic diaphragmatic hernia. Am Surg 69:160–162

  15. 15.

    Wadhwa A, Surendra JB, Sharma A, Khullar R, Soni V, Baijal M, Chowbey PK (2005) Laparoscopic repair of diaphragmatic hernias: experience of six cases. Asian J Surg 28:145–150

  16. 16.

    Rossetti G, Brusciano L, Maffettone V, Napolitano V, Sciaudone G, Del Genio G, Russo G, Del Genio A (2005) Giant post-traumatic diaphragmatic hernia: laparoscopic repair without a mesh. Chir Ital 57:243–246

  17. 17.

    Matthews BD, Bui H, Harold KL, Kercher KW, Adrales G, Park A, Sing RF, Heniford BT (2003) Laparoscopic repair of traumatic diaphragmatic injuries. Surg Endosc 17:254–258

  18. 18.

    Ver MR, Rakhlin A, Baccay F, Kaul B, Kaul A (2007) Minimally invasive repair of traumatic right-sided diaphragmatic hernia with delayed diagnosis. JSLS 11:481–486

  19. 19.

    Peker Y, Tatar F, Kahya MC, Cin N, Derici H, Reyan E (2007) Dislocation of three segments of the liver due to hernia of the right diaphragm. Hernia 11:63–65

  20. 20.

    McKellar SH, Matthews LR (2009) Traumatic diaphragmatic rupture with intrathoracic liver herniation. N Engl J Med 360:7

  21. 21.

    Robustelli U, Noschese G, Armellino MF, Gagliardi N, Festa P, Scardi F, Catuogno F (2009) Diaphragmatic rupture with intrathoracic hepatic dislocation: two case reports. G Chir 30:294–298

  22. 22.

    Collaud S, Remmen F, Weder W (2009) Transphrenic budding of the liver. Ann Thorac Surg 88:1364

  23. 23.

    Seket D, Henry L, Adham M, Partensky C (2009) Right-sided posttraumatic diaphragmatic rupture and delayed hepatic hernia. Hepatogastroenterology 56:504–507

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Valentino Fiscon, Giuseppe Portale, Giovanni Migliorini, and Flavio Frigo have no conflicts of interest or financial ties to disclose.

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Correspondence to Valentino Fiscon.

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Fiscon, V., Portale, G., Migliorini, G. et al. Laparoscopic repair of intrathoracic liver herniation after traumatic rupture of the diaphragm. Surg Endosc 25, 3423 (2011) doi:10.1007/s00464-011-1721-2

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  • G-I
  • Gut
  • Hepatic
  • Hernia
  • Liver
  • Surgical, technical