[Diaphragmatic hernia 3 years after the nephrectomy]

A 81-year-old man was referred to our department for the acute onset of dyspnea. Chest radiograph suggested a bowel shadow containing gases in the right chest. Computed tomography (CT) scan revealed the dislocation of the liver and the transverse colon in the right pleural cavity. Although the patient had no history of a blunt trauma, he had undergone the right nephrectomy for the renal cancer 3 years before. An emergency operation revealed the right lobe of the liver and the transverse colon profoundly entering into the right pleural cavity. The dislodged organs were gently restored through a dual approach, and the defect of the diaphragm was repaired with a prosthesis. The postoperative course was satisfactory. A diaphragmatic hernia sometimes occurs acutely and often shows life-threatening symptoms. The occurrence of the diaphragmatic hernia associated with previous surgery must be taken into account, when the procedure involved the diaphragm.