[Diaphragmatic Eventration Treated with Abdominal Organ Fixation by a Combination of Thoracoscopy and...

We report a case of diaphragmatic eventration treated by a combination of thoracoscopy and laparoscopy. A 49-year-old man was taken by ambulance to our hospital for emergency with a chief complaint of epigastric tightness and left-sided abdominal distention. A chest X-ray showed elevation of the left diaphragm, and diaphragmatic eventration was suspected, resulting in an initial visit to our department. A computed tomography (CT) of the thorax and abdomen showed that part of the liver, stomach, spleen, and colon splenic flexure were highly displaced cephalad, and the above symptoms were diagnosed as being caused by diaphragmatic eventration, and surgery was indicated because of the strong symptoms. The surgery was performed laparoscopically first because of the strong gastrointestinal symptoms and for safe thoracic manipulation, the stomach was suture-fixed to the diaphragmatic leg and the splenic flexure of the colon to the lateral abdomen. Next, thoracoscopic surgery was performed. The entire diaphragm was highly relaxed. The diaphragm was repaired first by resection with a stapler, followed by additional plication. The postoperative course was good, and the above symptoms disappeared completely.