A single-port video-assisted thoracoscopic surgery with CO2 insufflation for traumatic diaphragmatic hernia

In this article, we present 2 cases with successful reduction of herniated organs and repair of a ruptured diaphragm through a single-port video-assisted thoracoscopic surgery (VATS) approach using CO2 gas insufflation in haemodynamically stable patients. A CO2 insufflation was useful to push the diaphragm down and aided in reducing the size of the herniated organ. This approach did not cause damage to the herniated organs and no additional instrument or assistant was required. Thus, CO2 insufflation makes the single-port VATS procedure easier even in haemodynamically stable trauma patients.

Delayed presentation of a patient with a ruptured diaphragm complicated by gastric incarceration and perforation after apparently minor blunt trauma

ABSTRACTRupture of the diaphragm is almost always due to major trauma and is most commonly associated with road-traffic accidents. We report a case of delayed presentation of a 35-year-old woman with a ruptured diaphragm, 11 days following apparent minor blunt trauma. This case illustrates how the diagnosis of ruptured diaphragm can be missed and demonstrates the importance of considering this diagnosis in all cases of blunt trauma to the trunk. It also demonstrates the potential pitfall of misinterpreting the chest radiograph, and the value of repeat imaging after insertion of a nasogastric tube.