Iatrogenic diaphragmatic hernia due to laparoscopic gastric banding

Conventional mesh repair of a giant iatrogenic bilateral diaphragmatic hernia with an enterothorax

Purpose

Diaphragmatic hernias (DHs) are divided into congenital and acquired hernias, most of which are congenital. Among acquired DHs, up to 80% are left-sided, only a few iatrogenic DHs have been reported, and bilateral hernias are extremely rare. For diagnostic reasons, many DHs are overlooked by ultrasonography or X-ray and are only recognized at a later stage when complications occur.

Methods

In 2009, we performed three partial diaphragm replacements in our clinic for repairing DHs using a PERMACOL™ implant.

Results

As all patients had uneventful postoperative courses and the clinical outcomes were very good, we present one special case of a 65-year-old male with a giant iatrogenic bilateral DH with an enterothorax.

Conclusion

We see a good indication for diaphragm replacements by using a PERMACOL™ implant for fixing especially DHs with huge hernial gaps and in cases with fragile tissue.

Laparoscopic repair of a postadrenalectomy left-sided diaphragmatic hernia complicated by chronic colon obstruction

Iatrogenic diaphragmatic hernias are a rarely reported complication of abdominal surgery. We present a case of an iatrogenic diaphragmatic hernia diagnosed 2 years after an adrenalectomy. Corrective laparoscopic surgery was performed, and the postoperative course was uneventful. The patient remained asymptomatic 6 months after the repair. To our knowledge, this is the first such case to be reported.