title: Unusual repair in a rare case of hepatothorax due to right-sided diaphragmatic rupture: case report.
abstract: Intra-thoracic herniation of abdominal organs following diaphragmatic rupture represents an unusual clinical occurrence with great diagnostic difficulty. The authors present a case of right diaphragmatic rupture related to peritonitis due to perforated duodenal ulcer in previous (1 year before) thoraco-abdominal trauma with complete intra-thoracic herniation of the liver, gallbladder, ascending and transverse colon and lung collapse. The preoperative diagnosis has been based on clinical, chest X-ray, and ultrasound examination. The patient, because of very serious respiratory and hemodynamic distress, immediately underwent surgery (thoraco-laparotomic approach) with reduction of the liver, gallbladder, ascending and transverse colon in the abdominal cavity, perforated duodenal ulcer suture and repair of diaphragmatic tear using an unusual repair mode: suture of autologous fascia lata graft to the diaphragm. Postoperative chest radiography showed the normal location of right diaphragmatic border.
authors.forename: F
authors.initials: F
authors.lastname: Quadrozzi
authors.forename: P
authors.initials: P
authors.lastname: Favoriti
authors.forename: M
authors.initials: M
authors.lastname: Favoriti
authors.forename: G
authors.initials: G
authors.lastname: Cofini
mesh_terms: D000328:Adult; D044682:Colon, Ascending / Q000601:surgery; D044684:Colon, Transverse / Q000601:surgery; D004381:Duodenal Ulcer / Q000150:complications*; D005704:Gallbladder / Q000601:surgery; D006548:Hernia, Diaphragmatic / Q000000981:diagnostic imaging / Q000209:etiology / Q000382:microbiology* / Q000601:surgery*; D059685:Herniorrhaphy; D006801:Humans; D008099:Liver / Q000601:surgery; D008297:Male; D010538:Peritonitis / Q000150:complications / Q000382:microbiology*; D001261:Pulmonary Atelectasis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D012422:Rupture, Spontaneous / Q000209:etiology; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*