Clinical, surgical, and radiographic aspects in a white‑eared opossum (Didelphis albiventris) with traumatic diaphragmatic hernia

This is the case of a specimen of Didelphis albiventris with signs of respiratory difficulty after a dog attack. Thoracic radiographic examination revealed pneumothorax, pulmonary contusion, and rib fracture, but no alteration compatible with diaphragmatic hernia was observed. Pneumothorax was reduced and the other alterations were treated. However, clinical manifestations persisted, and thus a contrast-gastrointestinal radiographic study was performed, showing abdominal organs in the thoracic cavity and loss of diaphragmatic line. The surgical approach was instituted, with access to the diaphragm through median laparotomy. Through the diaphragmatic rupture, present in the left antimere, there were herniated liver and gastric portions, intestinal segments, and omentum. After inspection and repositioning of the abdominal organs, the diaphragm raffia was performed with single sutures interrupted with 3-0 Nylon thread. The patient’s complete recovery occurred 14 days after the surgical procedure, with remission of clinical manifestations and normality of thoracic images in radiographic studies.

Traumatic Diaphragmatic Hernia: Management and Review

Traumatic diaphragmatic injury (TDI) is a fairly uncommon with incidence of 0.8 and 1.6 %, commonest fallowing blunt trauma abdomen. Right-side have higher mortality rate compared to left side and penetrating injuries. It present as occult to obvious. Laparoscopy offers diagnostic and therapeutic tool of care. Lack of awareness of the condition may delay in diagnosis, results life threatening complications. Missed hernia is a known complication of blunt trauma as acute diagnosis can be difficult to ascertain. An early diagnosis and treatment lead to better outcome. In present study CECT revealed acute diaphragmatic hernia, bilateral pleural effusion and hair line fracture of right tibia on skiagram limb. Because of uncertainty in diagnosis of acute diaphragmatic hernia or rupture surgeons faces challenges for the management, high suspicion index required to diagnose the cases. An early diagnosis and treatment lead to better outcome

Treatment of Chronic Traumatic Diaphragmatic Hernia Based on Laparoscopic Repair: Experiences From 23 Cases

Background: We aimed to investigate the safety and effectiveness of laparoscopic repair for treating chronic traumatic diaphragmatic hernia (CTDH).Methods: In this retrospective analysis, we included 23 cases with CTDH underwent laparoscopy in our hospital between June 2015 and October 2019 was performed. The patient characteristics were recorded. We compared the diameter of hernia ring, surgery duration, intraoperative bleeding volume, means of repairing, as well as the follow-up data.Results: All the patients underwent laparoscopic diaphragmatic hernia repair, without conversion to laparotomy or thoracotomy. The operation time ranged from 60 min to 200 min (mean, 108.04 ± 42.93 min). The blood loss volume ranged from 10 to 300 ml (mean volume, 63.48 ± 71.69 ml). The postoperative hospital stayed ranged from 5 to 15 days (mean, 6.22 ± 2.11 days). The patients were followed up for 1–50 months (mean, 17.5 ± 10.90 months). No recurrence of diaphragmatic hernia was found.Conclusions: Laparoscopic repair of CTDH is featured by fast recovery, high security, and effectiveness. Reducing the hernia contents and close of the hernia ring are crucial for the surgery that is performed based on the size and location of the diaphragmatic hernia.

Tension Pneumothorax due to Colon Perforation in Delay Post Traumatic Diaphragmatic Hernia: Case Report

Diaphragmatic injuries were described first by Sennertus in 1541. Rupture of the diaphragm due to blunt trauma is a rare event that is usually not detected in the acute phase of trauma and may manifest itself late and with dangerous complications. The common side effects of this injury include displacement of the abdominal viscera into the thoracic cavity, which can cause respiratory problems due to limited lungs. Abdominal organs such as stomach, omentum, intestines, spleen, and liver are the most common to herniate in to the thoracic cavity .In late presentation, the key point is to identify the patient’s strong clinical suspicion and history. CT scan is the most common modality in diagnosis of diaphragmatic hernia. In this article, we introduce a unique case of diaphragmatic hernia after trauma due to falling from a height of 2 years ago, which showed itself with a tension pneumothorax in its management.