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Laparoscopic Repair of Blunt Traumatic Diaphragmatic Hernia

Traumatic diaphragmatic hernias (TDHs) can occur after both blunt and penetrating injury. Laparotomy and thoracotomy are commonly done for the management of TDHs. Minimally invasive surgery, especially laparoscopic surgery, is being accepted as an effective and safe alternative to open surgical repa...

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Autores principales: Yusufi, Maaz A, Uneeb, Muhammad, Nazir, Izza, Rashid, Farhan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10602394/
https://www.ncbi.nlm.nih.gov/pubmed/37900497
http://dx.doi.org/10.7759/cureus.46017
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author Yusufi, Maaz A
Uneeb, Muhammad
Nazir, Izza
Rashid, Farhan
author_facet Yusufi, Maaz A
Uneeb, Muhammad
Nazir, Izza
Rashid, Farhan
author_sort Yusufi, Maaz A
collection PubMed
description Traumatic diaphragmatic hernias (TDHs) can occur after both blunt and penetrating injury. Laparotomy and thoracotomy are commonly done for the management of TDHs. Minimally invasive surgery, especially laparoscopic surgery, is being accepted as an effective and safe alternative to open surgical repair even in trauma cases. Laparoscopy also allows for the detection and management of clinically occult TDHs, thereby preventing the complications of missed or delayed diagnosis. Our case highlights the importance of timely intervention with a minimally invasive approach. A 39-year-old male presented to the emergency room after a road traffic accident. Computed tomography scan confirmed left-sided diaphragmatic rupture with gastric herniation. Laparoscopic repair of the hernia was done. He had an uneventful post-operative period. At the one-year follow-up, he was asymptomatic and was doing well. TDHs have a variable clinical presentation and radiological findings are not always diagnostic. Such cases can progress to potentially life-threatening complications such as strangulation and perforation of the herniated viscera. Timely diagnosis and management are therefore essential. A minimally invasive approach such as laparoscopy should be used for the management of TDHs in the acute setting where the patient is stable, and resources are available. In this case, once the gastric contents were aspirated via a nasogastric tube in the middle of the night, the immediate need for surgery was converted to an urgent nature, and the patient underwent surgery the next morning in a more controlled setting. In addition, timely intervention can prevent future complications that may occur if the condition is left untreated during the initial admission.
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spelling pubmed-106023942023-10-27 Laparoscopic Repair of Blunt Traumatic Diaphragmatic Hernia Yusufi, Maaz A Uneeb, Muhammad Nazir, Izza Rashid, Farhan Cureus Cardiac/Thoracic/Vascular Surgery Traumatic diaphragmatic hernias (TDHs) can occur after both blunt and penetrating injury. Laparotomy and thoracotomy are commonly done for the management of TDHs. Minimally invasive surgery, especially laparoscopic surgery, is being accepted as an effective and safe alternative to open surgical repair even in trauma cases. Laparoscopy also allows for the detection and management of clinically occult TDHs, thereby preventing the complications of missed or delayed diagnosis. Our case highlights the importance of timely intervention with a minimally invasive approach. A 39-year-old male presented to the emergency room after a road traffic accident. Computed tomography scan confirmed left-sided diaphragmatic rupture with gastric herniation. Laparoscopic repair of the hernia was done. He had an uneventful post-operative period. At the one-year follow-up, he was asymptomatic and was doing well. TDHs have a variable clinical presentation and radiological findings are not always diagnostic. Such cases can progress to potentially life-threatening complications such as strangulation and perforation of the herniated viscera. Timely diagnosis and management are therefore essential. A minimally invasive approach such as laparoscopy should be used for the management of TDHs in the acute setting where the patient is stable, and resources are available. In this case, once the gastric contents were aspirated via a nasogastric tube in the middle of the night, the immediate need for surgery was converted to an urgent nature, and the patient underwent surgery the next morning in a more controlled setting. In addition, timely intervention can prevent future complications that may occur if the condition is left untreated during the initial admission. Cureus 2023-09-26 /pmc/articles/PMC10602394/ /pubmed/37900497 http://dx.doi.org/10.7759/cureus.46017 Text en Copyright © 2023, Yusufi et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiac/Thoracic/Vascular Surgery
Yusufi, Maaz A
Uneeb, Muhammad
Nazir, Izza
Rashid, Farhan
Laparoscopic Repair of Blunt Traumatic Diaphragmatic Hernia
title Laparoscopic Repair of Blunt Traumatic Diaphragmatic Hernia
title_full Laparoscopic Repair of Blunt Traumatic Diaphragmatic Hernia
title_fullStr Laparoscopic Repair of Blunt Traumatic Diaphragmatic Hernia
title_full_unstemmed Laparoscopic Repair of Blunt Traumatic Diaphragmatic Hernia
title_short Laparoscopic Repair of Blunt Traumatic Diaphragmatic Hernia
title_sort laparoscopic repair of blunt traumatic diaphragmatic hernia
topic Cardiac/Thoracic/Vascular Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10602394/
https://www.ncbi.nlm.nih.gov/pubmed/37900497
http://dx.doi.org/10.7759/cureus.46017
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