2011, Number 3
Late laparoscopic handling of a post-traumatic giant diaphragmatic hernia: report of one case
Mariñelarena MJL, Martínez-Contreras A, Aragon-Quintana C
Full text
Language: Spanish
References: 9
Page: 191-195
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ABSTRACT
Objective: To demonstrate the late laparoscopic handling for the repair of a post-traumatic giant hernia.Setting: Hospital CIMA Chihuahua, third level health care.
Design: Case description.
Case description. Male patient, 41-year-old, who 7 years before had been involved in a frontal automotive collision with loss of consciousness. Four months before his management, he started with weight loss and inability to retain food in the stomach. An esophageal-gastro-duodenal series was performed, which revealed a giant diaphragmatic hernia, gastric volvulus, the CAT scan evidenced hernia orifice in the left hemidiaphragm with gastric volvulus in the right hemithorax. Surgery was performed using a laparoscopic approach; the patient presented a bilateral pleural effusion, which on the 5th of surgery was restricted to the left side only, and resolving 15 days after surgery.
Conclusions: When stating that a post-traumatic diaphragmatic hernia is not diagnostic immediately after the event, then we can say that it has become a chronic problem. Repair of post-traumatic diaphragmatic hernias, although technically more complex, have as alternative the laparoscopic route and placement of prosthetic materials with good short- and median-term results, becoming the gold standard for their treatment when performed by expert hands and in appropriate medical centers.
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