Laparoscopic repair of chronic traumatic diaphragmatic hernia using biologic mesh with cholecystectomy for intrathoracic gallbladder.
OBJECTIVE
Diaphragmatic rupture is a serious complication of both blunt and penetrating abdominal trauma. In the acute setting, delay in diagnosis can lead to severe cardiovascular and respiratory compromise. Chronic cases can present years later with a plethora  of clinical symptoms. Laparoscopic techniques are being increasingly utilized in the diagnosis and treatment of traumatic diaphragmatic hernias.


METHODS
We describe a case of a 70-year-old female who presented with signs and symptoms of a small bowel obstruction. She was ultimately  found to have an obstruction secondary to a chronic traumatic diaphragmatic hernia with an intrathoracic gallbladder and incarcerated small intestine. A cholecystectomy and diaphragmatic hernia repair were both performed laparoscopically. This case report presents an atypical cause of bowel  obstruction and reviews the current literature on laparoscopic management of traumatic diaphragmatic hernias.


CONCLUSIONS
Laparoscopy is increasingly used in the diagnosis and treatment of traumatic diaphragmatic hernias with good results.
Mount Carmel Health System, Columbus, OH, USA. jpulido@neomed.edu
Jonathan
J
Pulido
Steven
S
Reitz
Suzanne
S
Gozdanovic
Phillip
P
Price
D000368:Aged; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006549:Hernia, Diaphragmatic, Traumatic / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D013526:Surgical Mesh; D014057:Tomography, X-Ray Computed