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Published on: September 27, 2024
Right-sided posttraumatic diaphragmatic rupture and delayed hepatic hernia
Belhassen Seket1, Luc Henry, Mustapha Adham
1Department of HepatoBilioPancreatic Surgery and Liver Transplantation, Edouard Herriot University Hospital, Lyon, France. hbseket@aol.com
Diagnosing traumatic diaphragmatic injuries is challenging, leading to missed cases and potential liver herniation years later. Prompt diagnosis and surgical repair are crucial to prevent severe complications.
Area of Science:
- Trauma Surgery
- Diagnostic Imaging
- Thoracic Surgery
Background:
- Posttraumatic diaphragmatic lesions are frequently missed due to limitations in radiographic sensitivity and specificity.
- Delayed diagnosis can result in herniation of abdominal contents, including the liver, into the thoracic cavity.
Observation:
- Two cases of delayed diaphragmatic injury diagnosis with liver herniation are presented, occurring 3 and 12 years post-trauma.
- Respiratory distress was the primary symptom in both cases, with one also involving the duodenum and pancreas.
Findings:
- Surgical management varied, including thoracotomy with mesh repair and laparotomy with direct suturing.
- Literature review analyzed different approaches for diaphragmatic repair following traumatic injury.
Implications:
- Highlights the difficulty in early diagnosis of diaphragmatic injuries and the severe consequences of missed diagnoses.
- Emphasizes the need for improved diagnostic strategies and timely surgical intervention for traumatic diaphragmatic defects.
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