A case of traumatic intercostal hernia treated by laparoscopic direct sutures Nozomu ISHIKAWA 1 , Osamu JINDOU 1 , Toshiya AKAI 1 , Akihiro UNO 1 , Atsuko FUKAZAWA 1 , Shohachi SUZUKI 1 1Department of Gastroenterological Surgery, Iwata City Hospital Keyword: 肋間ヘルニア , 外傷 , 腹腔鏡下手術 pp.509-514
Published Date 2019/11/15
DOI https://doi.org/10.11477/mf.4426200753
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 A 53-year-old woman was transferred to the emergency department following trauma to the left abdomen which was caused when she had lost consciousness and had fallen on top of the mouth of a 1.8 liter bottle. The trauma site was red and swollen, measuring 5-cm diameter. Traumatic intercostal hernia was revealed by CT scan. Cine CT scan showed the greater omentum prolapsing through the left diaphragm and thoracic cavity into the intercostal space. The diagnosis of traumatic transdiaphragmatic intercostal hernia was made. Laparoscopic finding showed incarceration of greater omentum through the defect of the left diaphragm. The orifice was closed using laparoscopic direct suture without any prosthesis. The patient is well without any complication or hernia recurrence, 10 months after surgery. We experienced an extremely rare case of transdiaphragmatic traumatic intercostal hernia. The cine CT scan was beneficial in identifying and diagnosing the traumatic site accurately and helping determine the surgical procedure.

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