Diagnostic Laparoscopy for Right Hemidiaphragm Rupture With Laparotomy Repair: A Case Report

James P. Bailey, Ryan D. Edwards


Post-traumatic hemidiaphragm rupture is a rare occurrence with a high mortality rate. The gold standard for diagnosis is exploratory laparotomy, which itself carries a high mortality rate in the emergent setting, as is commonly the case following blunt or penetrating abdominopelvic trauma. In this case, a 31-year-old patient with no significant medical history, who presented following an automobile accident with shoulder and gluteal pain with negative radiologic findings, was discussed. The goal of this case was to increase awareness of a possible alternative to the exploratory laparotomy for hemidiaphragm rupture in the emergent setting associated with lower mortality due to the operation. In this case, diagnostic laparoscopy was performed, and right hemidiaphragm was diagnosed. Repair was made via laparotomy with incorporation of the laparoscopic port incisions into the laparotomy incision. Repair was made using 2-0 interrupted non-absorbable sutures with both the anterior and posterior flaps of the hemidiaphragm supported with large pledgets. The patient tolerated the operation well, and has since recovered completely. This case demonstrates the possibility of utilizing minimally invasive techniques for the diagnosis of isolated diaphragm injury. Additionally, this case highlights the inadequacies of modern imaging technologies for the diagnosis of diaphragm injury, and supports the need of improvement in this technology or an alternative modality with increased sensitivity to rule out diaphragmatic injury.

J Curr Surg. 2016;6(1):33-36
doi: http://dx.doi.org/10.14740/jcs298w


Diaphragm rupture; Diagnostic laparoscopy; Trauma

Full Text: HTML PDF

Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics

World Journal of Oncology

Gastroenterology Research

Journal of Hematology

Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity

Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research

Journal of Neurology Research

International Journal of Clinical Pediatrics






Journal of Current Surgery, quarterly, ISSN 1927-1298 (print), 1927-1301 (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.currentsurgery.org   editorial contact: editor@currentsurgery.org
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.