Successful laparoscopic management of combined traumatic diaphragmatic rupture and abdominal wall hernia: a case report

Background: Traumatic diaphragmatic rupture and traumatic abdominal wall hernia are two well-described but rare clinical entities associated with blunt thoracoabdominal injuries. To the best of our knowledge, the combination of these two clinical entities as a result of a motor vehicle accident ha...

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Main Authors: Sze, Li Siow, Chee, Ming Wong, Mark, Hardin, Mushtag, Sohail
Format: Article
Language:English
Published: BioMed Central 2016
Subjects:
Online Access:http://ir.unimas.my/id/eprint/11494/
http://ir.unimas.my/id/eprint/11494/1/Successful%20laparoscopic%20management%20of%20combined%20traumatic%20diaphragmatic%20rupture%20%28abstract%29.pdf
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author Sze, Li Siow
Chee, Ming Wong
Mark, Hardin
Mushtag, Sohail
author_facet Sze, Li Siow
Chee, Ming Wong
Mark, Hardin
Mushtag, Sohail
author_sort Sze, Li Siow
building UNIMAS Institutional Repository
collection Online Access
description Background: Traumatic diaphragmatic rupture and traumatic abdominal wall hernia are two well-described but rare clinical entities associated with blunt thoracoabdominal injuries. To the best of our knowledge, the combination of these two clinical entities as a result of a motor vehicle accident has not been previously reported. Case presentation: A 32-year-old Indian man was brought to our emergency department after being involved in a road traffic accident. He described a temporary loss of consciousness and had multiple tender bruises at his right upper anterior abdominal wall and left lumbar region. An initial examination revealed blood pressure of 99/63 mmHg, heart rate of 107 beats/minute, and oxygen saturation of 93 % on room air. His clinical parameters stabilized after initial resuscitation. A computed tomographic scan revealed a rupture of the left diaphragm as well as extensive disruptions of the left upper anterior abdominal wall. We performed exploratory laparoscopic surgery with the intention of primary repair. The diaphragmatic and abdominal wall defect was primarily closed, followed by reinforcement with PROLENE onlay mesh. The patient’s postoperative recovery was complicated by infected hematomas over both flanks that were managed with ultrasound-guided percutaneous drainage. He was discharged well despite a prolonged hospital stay. Conclusions: We present a complex form of injuries managed successfully via a laparoscopic approach. Meticulous attention to potential complications in both the acute and convalescent phases is important for achieving a successful outcome following surgery.
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spelling unimas-114942016-10-21T02:12:10Z http://ir.unimas.my/id/eprint/11494/ Successful laparoscopic management of combined traumatic diaphragmatic rupture and abdominal wall hernia: a case report Sze, Li Siow Chee, Ming Wong Mark, Hardin Mushtag, Sohail RD Surgery Background: Traumatic diaphragmatic rupture and traumatic abdominal wall hernia are two well-described but rare clinical entities associated with blunt thoracoabdominal injuries. To the best of our knowledge, the combination of these two clinical entities as a result of a motor vehicle accident has not been previously reported. Case presentation: A 32-year-old Indian man was brought to our emergency department after being involved in a road traffic accident. He described a temporary loss of consciousness and had multiple tender bruises at his right upper anterior abdominal wall and left lumbar region. An initial examination revealed blood pressure of 99/63 mmHg, heart rate of 107 beats/minute, and oxygen saturation of 93 % on room air. His clinical parameters stabilized after initial resuscitation. A computed tomographic scan revealed a rupture of the left diaphragm as well as extensive disruptions of the left upper anterior abdominal wall. We performed exploratory laparoscopic surgery with the intention of primary repair. The diaphragmatic and abdominal wall defect was primarily closed, followed by reinforcement with PROLENE onlay mesh. The patient’s postoperative recovery was complicated by infected hematomas over both flanks that were managed with ultrasound-guided percutaneous drainage. He was discharged well despite a prolonged hospital stay. Conclusions: We present a complex form of injuries managed successfully via a laparoscopic approach. Meticulous attention to potential complications in both the acute and convalescent phases is important for achieving a successful outcome following surgery. BioMed Central 2016 Article PeerReviewed text en http://ir.unimas.my/id/eprint/11494/1/Successful%20laparoscopic%20management%20of%20combined%20traumatic%20diaphragmatic%20rupture%20%28abstract%29.pdf Sze, Li Siow and Chee, Ming Wong and Mark, Hardin and Mushtag, Sohail (2016) Successful laparoscopic management of combined traumatic diaphragmatic rupture and abdominal wall hernia: a case report. Journal of Medical Case Reports, 10 (1). ISSN 17521947 https://www.scopus.com/inward/record.url?eid=2-s2.0-84955098939&partnerID=40&md5=1d0cba8b21ec88153a23b1e95a2c5f35 DOI 10.1186/s13256-015-0780-8
spellingShingle RD Surgery
Sze, Li Siow
Chee, Ming Wong
Mark, Hardin
Mushtag, Sohail
Successful laparoscopic management of combined traumatic diaphragmatic rupture and abdominal wall hernia: a case report
title Successful laparoscopic management of combined traumatic diaphragmatic rupture and abdominal wall hernia: a case report
title_full Successful laparoscopic management of combined traumatic diaphragmatic rupture and abdominal wall hernia: a case report
title_fullStr Successful laparoscopic management of combined traumatic diaphragmatic rupture and abdominal wall hernia: a case report
title_full_unstemmed Successful laparoscopic management of combined traumatic diaphragmatic rupture and abdominal wall hernia: a case report
title_short Successful laparoscopic management of combined traumatic diaphragmatic rupture and abdominal wall hernia: a case report
title_sort successful laparoscopic management of combined traumatic diaphragmatic rupture and abdominal wall hernia: a case report
topic RD Surgery
url http://ir.unimas.my/id/eprint/11494/
http://ir.unimas.my/id/eprint/11494/
http://ir.unimas.my/id/eprint/11494/
http://ir.unimas.my/id/eprint/11494/1/Successful%20laparoscopic%20management%20of%20combined%20traumatic%20diaphragmatic%20rupture%20%28abstract%29.pdf