Iatrogenic diaphragmatic hernia and intestinal obstruction following laparoscopic hepatectomy: A case report

Abstract

Diaphragmatic hernias may be either congenital or acquired. Acquired diaphragmatic hernias generally develop in association with blunt or penetrating thoraco-abdominal injuries. Iatrogenic diaphragmatic hernias are rare in the literature. Traumatic diaphragmatic ruptures are diagnosed during the imaging tests performed due to accompanying organ injuries or during surgery. However, acquired diaphragmatic hernias developing in the late postoperative period are uncommon, and the difficulties in diagnosis may result in increased mortality and morbidity. The use of electrocautery and other electric devices during the release of hepatic ligaments is thought to result in diaphragmatic hernias in the late period of diaphragmatic injuries that are missed during surgery. We describe the diagnosis and the therapeutic course of a case undergoing laparoscopic right hepatectomy due to hepatic alveolar echinococcosis and taken for emergency surgery with diagnoses of diaphragmatic hernia and intestinal obstruction approximately 20 months subsequently in the light of the current literature.

Keywords

• diaphragmatic hernia
• hepatectomy
• diaphragmatic injury
• intestinal obstruction