Laparoscopic repair of an incarcerated diaphragmatic hernia after right hepatectomy for hepatic injury: a case report

Abstract Background Diaphragmatic hernias (DH) are generally classified as either congenital or acquired. Acquired DH are generally of traumatic cause, being a rare complication after hepatectomy. Although repair of a DH can be performed via laparotomy, laparoscopy, or thoracoscopy, the use of lapar...

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Main Authors: Shohei Takaichi, Tsuyoshi Takahashi, Soichiro Funaki, Koji Tanaka, Yasuhiro Miyazaki, Tomoki Makino, Yukinori Kurokawa, Makoto Yamasaki, Kiyokazu Nakajima, Meinoshin Okumura, Masaki Mori, Yuichiro Doki
Format: Article
Language:English
Published: Japan Surgical Society 2018-11-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-018-0542-0
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author Shohei Takaichi
Tsuyoshi Takahashi
Soichiro Funaki
Koji Tanaka
Yasuhiro Miyazaki
Tomoki Makino
Yukinori Kurokawa
Makoto Yamasaki
Kiyokazu Nakajima
Meinoshin Okumura
Masaki Mori
Yuichiro Doki
author_facet Shohei Takaichi
Tsuyoshi Takahashi
Soichiro Funaki
Koji Tanaka
Yasuhiro Miyazaki
Tomoki Makino
Yukinori Kurokawa
Makoto Yamasaki
Kiyokazu Nakajima
Meinoshin Okumura
Masaki Mori
Yuichiro Doki
author_sort Shohei Takaichi
collection DOAJ
description Abstract Background Diaphragmatic hernias (DH) are generally classified as either congenital or acquired. Acquired DH are generally of traumatic cause, being a rare complication after hepatectomy. Although repair of a DH can be performed via laparotomy, laparoscopy, or thoracoscopy, the use of laparoscopy is rare after hepatectomy owing to the formation of scar tissue. In this case, we describe our successful attempt at laparoscopic repair of a recurrent DH after hepatectomy. Case presentation A 30-year-old man underwent right hepatectomy for trauma and thoracotomy via the eighth intercostal space, with direct closure of the diaphragm by suturing. The patient subsequently developed a right DH, with strangulation ileus of the small intestine. He underwent laparotomy 3 months after the initial surgery. The defect was observed to be clearly separate from the previously sutured area of the diaphragm. Five years after treatment, the patient developed abdominal pain and vomiting due to incarceration of the transverse colon in the right intrathoracic space (detected via abdominal computed tomography and radiography). The patient was again diagnosed with DH and underwent laparoscopic repair of the hernia with direct closure. The patient was discharged 11 days after surgery without further complication. Conclusions A laparoscopic approach was feasibly and safely used to repair a recurrent DH after hepatectomy. The surgical approach will need to be decided in a patient-specific manner.
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spelling doaj-art-fbca846d527746dd8905747c261f6f6e2025-08-20T03:58:04ZengJapan Surgical SocietySurgical Case Reports2198-77932018-11-01411410.1186/s40792-018-0542-0Laparoscopic repair of an incarcerated diaphragmatic hernia after right hepatectomy for hepatic injury: a case reportShohei Takaichi0Tsuyoshi Takahashi1Soichiro Funaki2Koji Tanaka3Yasuhiro Miyazaki4Tomoki Makino5Yukinori Kurokawa6Makoto Yamasaki7Kiyokazu Nakajima8Meinoshin Okumura9Masaki Mori10Yuichiro Doki11Department of Gastroenterological Surgery, Osaka University Graduate School of MedicineDepartment of Gastroenterological Surgery, Osaka University Graduate School of MedicineDepartment of respiratory Surgery, Osaka University Graduate School of MedicineDepartment of Gastroenterological Surgery, Osaka University Graduate School of MedicineDepartment of Gastroenterological Surgery, Osaka University Graduate School of MedicineDepartment of Gastroenterological Surgery, Osaka University Graduate School of MedicineDepartment of Gastroenterological Surgery, Osaka University Graduate School of MedicineDepartment of Gastroenterological Surgery, Osaka University Graduate School of MedicineDepartment of Gastroenterological Surgery, Osaka University Graduate School of MedicineToneyama National HospitalDepartment of Gastroenterological Surgery, Osaka University Graduate School of MedicineDepartment of Gastroenterological Surgery, Osaka University Graduate School of MedicineAbstract Background Diaphragmatic hernias (DH) are generally classified as either congenital or acquired. Acquired DH are generally of traumatic cause, being a rare complication after hepatectomy. Although repair of a DH can be performed via laparotomy, laparoscopy, or thoracoscopy, the use of laparoscopy is rare after hepatectomy owing to the formation of scar tissue. In this case, we describe our successful attempt at laparoscopic repair of a recurrent DH after hepatectomy. Case presentation A 30-year-old man underwent right hepatectomy for trauma and thoracotomy via the eighth intercostal space, with direct closure of the diaphragm by suturing. The patient subsequently developed a right DH, with strangulation ileus of the small intestine. He underwent laparotomy 3 months after the initial surgery. The defect was observed to be clearly separate from the previously sutured area of the diaphragm. Five years after treatment, the patient developed abdominal pain and vomiting due to incarceration of the transverse colon in the right intrathoracic space (detected via abdominal computed tomography and radiography). The patient was again diagnosed with DH and underwent laparoscopic repair of the hernia with direct closure. The patient was discharged 11 days after surgery without further complication. Conclusions A laparoscopic approach was feasibly and safely used to repair a recurrent DH after hepatectomy. The surgical approach will need to be decided in a patient-specific manner.http://link.springer.com/article/10.1186/s40792-018-0542-0Diaphragmatic herniaRight hepatectomyLaparoscopic surgery
spellingShingle Shohei Takaichi
Tsuyoshi Takahashi
Soichiro Funaki
Koji Tanaka
Yasuhiro Miyazaki
Tomoki Makino
Yukinori Kurokawa
Makoto Yamasaki
Kiyokazu Nakajima
Meinoshin Okumura
Masaki Mori
Yuichiro Doki
Laparoscopic repair of an incarcerated diaphragmatic hernia after right hepatectomy for hepatic injury: a case report
Surgical Case Reports
Diaphragmatic hernia
Right hepatectomy
Laparoscopic surgery
title Laparoscopic repair of an incarcerated diaphragmatic hernia after right hepatectomy for hepatic injury: a case report
title_full Laparoscopic repair of an incarcerated diaphragmatic hernia after right hepatectomy for hepatic injury: a case report
title_fullStr Laparoscopic repair of an incarcerated diaphragmatic hernia after right hepatectomy for hepatic injury: a case report
title_full_unstemmed Laparoscopic repair of an incarcerated diaphragmatic hernia after right hepatectomy for hepatic injury: a case report
title_short Laparoscopic repair of an incarcerated diaphragmatic hernia after right hepatectomy for hepatic injury: a case report
title_sort laparoscopic repair of an incarcerated diaphragmatic hernia after right hepatectomy for hepatic injury a case report
topic Diaphragmatic hernia
Right hepatectomy
Laparoscopic surgery
url http://link.springer.com/article/10.1186/s40792-018-0542-0
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