EXTENSIVE ABDOMINOPLEURAL ORGAN DISLOCATION VIA A DAMAGED DIAPHRAGM

Relevance. The problem of post-traumatic diaphragmatic dome defects and abdominothoracic organ displacement remains relevant due to the frequency of combined open and closed chest injuries, late diagnosis, and high latency in cases of intestinal loop strangulation and necrosis.

Aim: To review our experience in the management of post-traumatic massive abdominothoracic dislocation of the right lobe of the liver, small and large intestines, and the greater omentum into the right hemithorax.

Case report. A 63-year-old man presented with a suspected right side post-traumatic diaphragmatic hernia. Five years ago, he had incurred a traffic accident with multiple rib fractures. After a physical examination and computed tomography scan imaging, the diagnosis was confirmed. The operation was performed using abdominal and thoracic approaches.

Results. Postoperative running was uneventful. The patient was discharged with recovery. Examination in 6 months showed adequate physical activity and absence of complaints. Breathing in the lungs was symmetrical. The overall chest roentgenogram demonstrated the consolidation of fractured ribs, and the lungs without visible pathology.

Conclusion. Herniation of the abdominal organs into the right hemithorax induced clinical manifestations of respiratory failure and dyspepsia which progressed. The diagnosis was made immediately after the patient’s presentation. The planned surgery was successful and prevented strangulation of the internal organs.

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