Related Experiment Video
Updated: Sep 26, 2026

Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
Delayed Right Hemidiaphragm Rupture After Blunt Trauma Repaired With Prolene Mesh: A Case Report
Zahra Sadin1, Aghajanzadeh Manochehr1, Sadin Mohammadreza2
1Department of Thoracic Surgery, Guilan University of Medical Sciences, Rasht, Iran, gums.ac.ir.
Abstract:
Traumatic diaphragmatic rupture (TDR) is a rare but serious injury. It most commonly results from high-impact blunt trauma. Right-sided ruptures are particularly uncommon due to the protective effect of the liver. Delayed presentation can cause diagnostic challenges, as the injury may remain clinically silent for years before complications such as organ herniation. We report a case of a 65-year-old male who presented with progressive dyspnea, right-sided chest pain, and right upper quadrant abdominal discomfort 4 years after a severe motor vehicle accident. Chest radiography revealed a heterogeneous opacity in the right hemithorax, and contrast-enhanced CT confirmed right hemidiaphragmatic rupture with intrathoracic herniation of the liver. The patient underwent urgent surgical repair. A large diaphragmatic defect was identified and repaired with a Prolene mesh in a tension-free fashion. The postoperative course was uneventful, with complete resolution of symptoms. This case highlights the importance of maintaining clinical suspicion for delayed diaphragmatic rupture in patients with a remote history of blunt trauma, even when initial imaging was normal. Contrast-enhanced CT remains the diagnostic standard, and Prolene mesh repair is a surgical solution for large diaphragmatic defects.
Related Concept Videos
Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
Esophageal Perforation-II: Clinical Manifestations and Management
Clinical Manifestations:
Pneumothorax II: Pathophysiology
Esophageal Perforation-I: Introduction
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
Flail Chest-I
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...