Adult right-sided strangulated diaphragmatic hernia with history of open nephrectomy: a case report

We present a case involving a 76-year-old man who developed a strangulated diaphragmatic hernia 14 years after undergoing an open right nephrectomy for renal cell carcinoma. The patient presented with lower abdominal pain, vomiting, and constipation. Imaging studies revealed an obstructed segment of the bowel herniating through a defect in the posterior right hemidiaphragm, along with signs of strangulation. An urgent laparotomy was performed, during which a right hemicolectomy was conducted. Despite experiencing hemodynamic instability, the patient eventually underwent an ileocolic anastomosis and a primary repair of the diaphragmatic defect. He made a rapid recovery and was discharged in stable condition. This case report aims to raise awareness about the risk of inadvertent diaphragmatic injury during open nephrectomy. It also emphasizes the importance of timely diagnosis and appropriate surgical management to prevent complications and improve patient outcomes.