Iatrogenic diaphragmatic hernia and intestinal obstruction following laparoscopic hepatectomy: A case report

Abstract Diaphragmatic hernias may be either congenital or acquired. Acquired diaphragmatic

hernias generally develop in association with blunt or penetrating thoraco-abdominal

injuries. Iatrogenic diaphragmatic hernias are rare in the literature. Traumatic

diaphragmatic ruptures are diagnosed during the imaging tests performed due to

accompanying organ injuries or during surgery. However, acquired diaphragmatic hernias

developing in the late postoperative period are uncommon, and the difficulties in diagnosis

may result in increased mortality and morbidity. The use of electrocautery and other

electric devices during the release of hepatic ligaments is thought to result in

diaphragmatic hernias in the late period of diaphragmatic injuries that are missed during

surgery.

We describe the diagnosis and the therapeutic course of a case undergoing laparoscopic

right hepatectomy due to hepatic alveolar echinococcosis and taken for emergency surgery

with diagnoses of diaphragmatic hernia and intestinal obstruction approximately 20

months subsequently in the light of the current literature.

Keywords  diaphragmatic hernia, hepatectomy, diaphragmatic injury, intestinal obstruction

Highlights ✓ Minor traumas occurring in the diaphragm during surgery may gradually result in hernias.

✓ The post-hepatectomy DH is an exceedingly rare, but life-threatening condition.

✓ Delayed dıagnosis and treatment may result in severe morbidity and mortality