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Dislocation of three segments of the liver due to hernia of the right diaphragm

Report of a case and review of the literature

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Abstract

Right diaphragmatic hernia is a rare injury (0.25–1%) following blunt abdominal trauma. The diagnosis may be delayed and achieved years after the trauma during laparotomies for other reasons. A 75-year-old male fell 6 years before, and was symptom-free since then. He was admitted to the hospital for abdominal pain, and chest X-rays revealed intestinal gas in the lower right thoracal region. Abdominal ultrasonography showed agenesis of the gallbladder, and computed tomography demonstrated that the right upper abdominal viscera were located in the vicinity of the heart. The patient underwent a laparotomy for right diaphragmatic hernia, and the right hepatic lobe and the medial segment of the left lobe, the gall bladder, the proximal part of the transverse colon, the omentum and some segments of the intestine were dislocated into the thoracal cavity by a tear in the right diaphragm. The organs were returned to the abdominal cavity uneventfully and the defect in the diaphragm, measuring 10 × 5 cm, was repaired by unabsorbable sutures. The diagnosis, surgical treatment and postoperative course of the right diaphragmatic hernia is discussed with a review of the literature.

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References

  1. Wirbel RJ, Mutschler W. (1998) Blunt rupture of the right hemi-diaphragm with complete dislocation of the right hepatic lobe: report of a case. Surg Today 8:850–852

    Article  Google Scholar 

  2. Stagnitti F, Priore F, Corona F, Tiberi R, De Pasalis M, Schillaci F, Costantini A, Natalini E (2004) Traumatic lesions of the diaphragm. G Chir 8–9:276–282

    Google Scholar 

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

    Article  Google Scholar 

  4. Genotelle N, Lherm T, Gontier O, Le Gall C, Caen D (2004) Right uncontrollable haemothorax revealing a liver injury with diaphragmatic rupture. Ann Fr Anesth Reanim 8:831–834

    Google Scholar 

  5. 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

    Google Scholar 

  6. Tiberio GA, Portolani N, Coniglio A, Baiocchi GL, Vettoretto N, Giulini SM. (2005) Traumatic lesions oh the diapgragm. Our experince in 33 cases and review of the literature. Acta Chir Belg 1:82–88

    Google Scholar 

  7. Rubikas R. (2001) Diaphragmatic injuries. Eur J Cardiothrorac Surg 1:53–7

    Article  Google Scholar 

  8. Vermillion J, Wilson E, Smith R (2001) Traumatic diaphragmatic hernia presenting as a tension fecopneumothorax. Hernia 5:158–160

    Article  PubMed  CAS  Google Scholar 

  9. Hoang AD, De Backer D, Bouazza F, Capella M, De Francquen P, Rocmans P (2002) Undiagnosed rupture of right hemidiaphragm–hepatothorax: a case report. Acta Chir Belg 5:353–365

    Google Scholar 

  10. Ould-Ahmed M, Choplain JN, Andre M, Mondine P, Potier L (2005) Delayed and fortuitous diagnosis of right diaphragmatic rupture during preoperative evaluation. Ann Fr Anesth Reanim 4:416–420

    Google Scholar 

  11. Strug B, Noon GB (1974) Traumatic hernia. Am Thorac Surg 17:442–449

    Article  Google Scholar 

  12. Cubukcu A, Paksoy M, Gonullu NN, Sirin F, Dulger M (2000) Traumatic rupture of the diaphragm. Int J Clin Pract 1:19–21

    Google Scholar 

  13. Bergin D, Ennis R, Keogh C, Fenlon HM, Murray JG (2001) The “dependent viscera” sign in CT diagnosis of blunt traumatic diaphragmatic rupture. Am J Roentgenol 5:1137–1140

    Google Scholar 

  14. Patselas TN, Gallagher EG (2002) The diagnostic dilemma of diaphragm injury. Am Surg 68:633–639

    PubMed  Google Scholar 

  15. Conze J, Rosch R, Klinge U, Weiss C, Anurov M, Titkowa S, Oettinger A, Schumpelick V (2004) Polypropylene in the intra-abdominal position: influence of pore size and surface area. Hernia 8:365–372

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Y. Peker.

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Peker, Y., Tatar, F., Kahya, M.C. et al. Dislocation of three segments of the liver due to hernia of the right diaphragm. Hernia 11, 63–65 (2007). https://doi.org/10.1007/s10029-006-0138-7

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  • DOI: https://doi.org/10.1007/s10029-006-0138-7

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