Jee Yeseob
Department of Surgery, Dankook University Hospital, Cheonan, South Korea.
Wideochir Inne Tech Maloinwazyjne. 2017 Jun;12(2):189-193. doi: 10.5114/wiitm.2017.66373. Epub 2017 Mar 10.
Traumatic diaphragmatic hernia (TDH) is an uncommon surgical problem, and diagnosis is often delayed. However, the mortality from bowel necrosis can reach 80%. Therefore, suspicion is needed and surgery is required to prevent complications. A 50-year-old man was transferred due to abdominal pain and vomiting. Chest X-ray and computed tomography (CT) scan showed herniation of the stomach through the left diaphragm. The patient had fallen down 15 months ago and CT scan at that time revealed a small defect of the diaphragm without herniation. We diagnosed delayed herniation of TDH and the patient underwent laparoscopic repair using an expanded polytetrafluoroethylene (ePTFE) mesh. Recovery was uneventful and the CT scan at 3 months after the operation showed no recurrence. We reported a delayed presenting TDH and considered a laparoscopic approach to be safe and feasible during elective surgery. Moreover, use of an ePTFE mesh for repair of large diaphragmatic hernia was also feasible.
创伤性膈疝（TDH）是一种不常见的外科问题，诊断往往会延迟。然而，肠坏死导致的死亡率可达80%。因此，需要保持怀疑并进行手术以预防并发症。一名50岁男性因腹痛和呕吐被转诊。胸部X线和计算机断层扫描（CT）显示胃通过左膈疝出。该患者15个月前摔倒，当时的CT扫描显示膈有一个小缺损但无疝出。我们诊断为TDH延迟性疝出，患者接受了使用膨体聚四氟乙烯（ePTFE）补片的腹腔镜修补术。恢复过程顺利，术后3个月的CT扫描显示无复发。我们报告了一例延迟出现的TDH，并认为在择期手术中腹腔镜手术方法是安全可行的。此外，使用ePTFE补片修复大型膈疝也是可行的。
