Emergency laparoscopic surgery for post-traumatic incarcerated diaphragmatic hernia: Defect closure and intraperitoneal mesh manual fixation

摘要

A 39 years old male patient was referred to our hospital, for acute abdominal pain resistant to painkiller drugs and cough, dyspnoea and signs of initial bowel obstruction. Abdomen was tense with peri- toneal irritation. Computed tomography scan revealed migration of viscera in the left thoracic cavity through a diaphragmatic defect, with lung compression. Emergency surgery was performed; explora- tion confirmed translocation in thorax of all omentum, transverse colon and bowel loops. By slow tractions, the content was reduced in the abdominal cavity exposing a 3 cm diaphragmatic hole without hernia sac. We performed a double layer continuous and interrupted non-absorbable suture. Non absorbable mesh was fixed over the hole by interrupted stitches; biological glue was used to better seal- ing. No chest or abdominal drain was placed. No complications was reported and he was discharged after 3 days. No complications were reported to one month [Fig. 1].