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Thoraco-phreno-laparotomy for a delayed presentation of a left diaphragmatic hernia

Delivery of the necrotic colon

Denis Allard, Trauma Surgeon, GF Jooste, Cape Town


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Case Presentations

Traumatic diaphragmatic Injury (Right side)

b banga, December 22, 2010

A middle aged female presented with multiple # ribs and right side haemothorax after a road accident. A chest tube was put in to drain the hemothorax. She was comfortable, no respiratory distress and maintaining the oxygen saturation without oxygen supplementation. There is decrease air entry at base and check X-ray revealed markedly elevated diaphragm on Rt. Side.

C.T.Chest-suspicion of traumatic diaphragmatic hernia with herniation of liver in thorax. I planned lateral thoracotomy through 7th I.C.space. Before opening I put Laparoscope through chest tube site and confirmed the diagnosis. Liver and a part of colon were in thorax. After opening both structures could be reduced easily. Rent in diaphragm repaired with 1/0 Prolene suture. Post operative – uneventful recovery

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