title: Intrathoracal cholecystitis calculosa in a right-sided posttraumatic diaphragmatic hernia: a case report.
abstract: BACKGROUND
  Injuries of the diaphragm were first described in 1541 by Sennertus and the initial repair was performed by Riolfi in 1886. Posttraumatic diaphragmatic hernia in adults is usually caused by blunt trauma and may remain asymptomatic and undiagnosed for many years. Right-sided tears are significantly less likely than left-sided tears because of the protective effect of the liver. They are associated with high mortality and morbidity. The rupture of the right side of the diaphragm and the presence of an inflamed gallbladder in the thoracic cavity are uncommon.
  
  
  METHODS
  We present the case of a 57-year-old Albanian man with prolapses of his gallbladder and other abdominal organs into the thoracic cavity through the herniation of his right hemidiaphragm due to trauma. The diaphragmatic hernia and gallstones seen in the thorax computed tomography scan were diagnostic. The organs herniated to the thoracic cavity were placed back into the abdominal cavity, a cholecystectomy was performed and the defect in the diaphragm was repaired with a prolene mesh graft during the operation. The patient was discharged 10 days after the surgical procedure, and no complications were reported.
  
  
  CONCLUSIONS
  Diaphragmatic hernia should be considered as a possible diagnosis in patients with respiratory disorders or unusual shadows in the thoracic region after recently sustained injury or with a history of injury. The prolapse of a gallbladder is rare. The symptoms are uncharacteristic and patients with this disease may remain without symptoms for a long period. Treatment is surgical.
authors.affiliation: University Clinical Center of Kosova, Clinic of Surgery, Rrethi i Spitalit pn, Prishtina, 10000, Republic of Kosova. dr.afrimi@hotmail.com.
authors.forename: Laura L
authors.initials: LL
authors.lastname: Tahiri
authors.forename: Afrim
authors.initials: A
authors.lastname: Tahiri
authors.forename: Rifat
authors.initials: R
authors.lastname: Bajrami
authors.forename: Shpresa
authors.initials: S
authors.lastname: Hasimja
authors.forename: Antigona
authors.initials: A
authors.lastname: Hasani
references.citation: Rev Gastroenterol Peru. 2008 Jul-Sep;28(3):244-7
references.pmid: 18958140
references.citation: Ann Surg. 1993 Dec;218(6):783-90
references.pmid: 8257229
references.citation: J Cardiovasc Surg (Torino). 1998 Dec;39(6):859-61
references.pmid: 9972916
references.citation: Injury. 1998 Jul;29(6):479-80
references.pmid: 9813710
references.citation: Surg Today. 1998;28(8):850-2
references.pmid: 9719010
references.citation: World J Emerg Surg. 2011 Jan 18;6:3
references.pmid: 21244704
references.citation: Ann Thorac Surg. 2010 Sep;90(3):1024
references.pmid: 20732546
references.citation: Hernia. 2007 Feb;11(1):63-5
references.pmid: 16969586
references.citation: Ann Surg. 1945 Aug;122(2):191-6
references.pmid: 17858646
references.citation: Nihon Kyobu Geka Gakkai Zasshi. 1993 Oct;41(10):2131-5
references.pmid: 8228421
references.citation: Hernia. 2008 Feb;12(1):73-8
references.pmid: 17891332
references.citation: J Am Coll Surg. 2007 Jan;204(1):176
references.pmid: 17189127
references.citation: CJEM. 2004 Jul;6(4):277-80
references.pmid: 17382006
references.citation: Ugeskr Laeger. 2009 Jan 5;171(1-2):33-4
references.pmid: 19128562
references.citation: Zentralbl Chir. 1994;119(10):730-2
references.pmid: 7801713
references.citation: Anesth Analg. 2007 Jan;104(1):224-5
references.pmid: 17179293
references.citation: Am Fam Physician. 1992 Aug;46(2):453-6
references.pmid: 1636561
references.citation: Surg Clin North Am. 2010 Oct;90(5):955-68
references.pmid: 20955877