title: Partial liver herniation into the right chest following trauma: a delayed presentation as acute injury managed by laparoscopically assisted mini-thoracotomy.
abstract: BACKGROUND
  Traumatic diaphragmatic rupture is a relatively uncommon occurrence, with an incidence of 0.8-5% reported in the literature. The reported percentage of missed diaphragmatic injuries that were discovered later ranges from 12 to 66%. Herniation of the liver through the right diaphragm has been reported in the literature after liver transplantation, and in trauma populations.
  
  
  METHODS
  Here, we report a case of late identification of partial liver herniation into the right chest (8 years post initial injury), due to a recent motor vehicle crash. Thought to be suffering from an acute injury, the patient was taken to the operating room and a laparoscopically assisted mini-thoracotomy was performed. An old diaphragmatic injury was found intraoperatively; laparoscopically assisted mini-thoracotomy was used to repair the diaphragm, and the liver was returned into the abdomen.
  
  
  CONCLUSIONS
  Right-sided diaphragmatic laceration, if diagnosed at the time of injury, may be repaired with the minimally invasive technique we describe here.
authors.affiliation: Division of Trauma, Critical Care and Emergency Surgery, Department of Surgery, University of Arizona, 1501 N. Campbell Avenue, Tucson, AZ, 85724, USA.
authors.forename: C
authors.initials: C
authors.lastname: Diven
authors.affiliation: Division of Trauma, Critical Care and Emergency Surgery, Department of Surgery, University of Arizona, 1501 N. Campbell Avenue, Tucson, AZ, 85724, USA. Latifi@surgery.arizona.edu.|Trauma Services, Hamad Medical Corporation, Doha, Qatar. Latifi@surgery.arizona.edu.
authors.forename: R
authors.initials: R
authors.lastname: Latifi
keywords: Delayed presentation; Diaphragmatic injury; Laparoscopic assisted mini-thoracotomy; Laparoscopic repair
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