Minimally invasive repair of right-sided blunt traumatic diaphragmatic injury. Issue 11 (4th November 2020)

• Record Type: Journal Article
• Authors: Shichiri, Keiko; Imamura, Kiyotaka; Takada, Minoru; Anbo, Yoshiyasu
• Is Part Of: BMJ case reports. Volume 13:Issue 11(2020)
• Publication Date: 2020-11-04
• Subjects: surgery -- general surgery -- orthopaedic and trauma surgery; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2020-235870
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Right-sided blunt traumatic diaphragmatic injury (TDI) is a rare injury that is rarely repaired by the minimally invasive approach in the acute setting. Laparoscopic repair of right-sided TDI is challenging because the liver often obstructs access to the injury site. Herein, we report a case wherein acute right-sided blunt TDI was successfully repaired using a combined laparoscopic and thoracoscopic approach. A 30-year-old man presented with shortness of breath after falling on his back while jumping on a snowboard. CT revealed a right-sided TDI. As the patient was haemodynamically stable, laparoscopic repair was planned. Laparoscopy revealed a right-sided diaphragmatic rupture. As the posterior portion was covered by the liver and difficult to access, we added trocars in the chest cavity and closed the diaphragmatic defect with a thoracic approach. A combined laparoscopic and thoracoscopic approach can repair right-sided diaphragmatic injury by a minimally invasive approach even in the acute setting.