Successful laparoscopic management of combined traumatic diaphragmatic rupture and abdominal wall hernia: a case report
Background: Traumatic diaphragmatic rupture and traumatic abdominal wall hernia are two well-described but rare clinical entities associated with blunt thoracoabdominal injuries. To the best of our knowledge, the combination of these two clinical entities as a result of a motor vehicle accident ha...
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| Main Authors: | , , , |
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| Format: | E-Article |
| Language: | English |
| Published: |
BioMed Central
2016
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| Subjects: | |
| Online Access: | http://ir.unimas.my/id/eprint/11494/1/Successful%20laparoscopic%20management%20of%20combined%20traumatic%20diaphragmatic%20rupture%20%28abstract%29.pdf http://ir.unimas.my/id/eprint/11494/ https://www.scopus.com/inward/record.url?eid=2-s2.0-84955098939&partnerID=40&md5=1d0cba8b21ec88153a23b1e95a2c5f35 |
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| Institution: | Universiti Malaysia Sarawak |
| Language: | English |
| Summary: | Background: Traumatic diaphragmatic rupture and traumatic abdominal wall hernia are two well-described but rare
clinical entities associated with blunt thoracoabdominal injuries. To the best of our knowledge, the combination of
these two clinical entities as a result of a motor vehicle accident has not been previously reported.
Case presentation: A 32-year-old Indian man was brought to our emergency department after being involved in a
road traffic accident. He described a temporary loss of consciousness and had multiple tender bruises at his right upper
anterior abdominal wall and left lumbar region. An initial examination revealed blood pressure of 99/63 mmHg, heart
rate of 107 beats/minute, and oxygen saturation of 93 % on room air. His clinical parameters stabilized after initial
resuscitation. A computed tomographic scan revealed a rupture of the left diaphragm as well as extensive disruptions
of the left upper anterior abdominal wall. We performed exploratory laparoscopic surgery with the intention of primary
repair. The diaphragmatic and abdominal wall defect was primarily closed, followed by reinforcement with PROLENE
onlay mesh. The patient’s postoperative recovery was complicated by infected hematomas over both flanks that were
managed with ultrasound-guided percutaneous drainage. He was discharged well despite a prolonged hospital stay.
Conclusions: We present a complex form of injuries managed successfully via a laparoscopic approach. Meticulous
attention to potential complications in both the acute and convalescent phases is important for achieving a successful
outcome following surgery. |
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