c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Incidental Diaphragmatic Hernia: 1

A D V E R T I S E M E N T

   
 

A 47-year-old male had a positive FAST exam and was hemodynamically unstable after a motor vehicle accident. He underwent abdominal exploration, small bowel resection and tissue sealant placed on a grade I liver laceration. Exploration also revealed an old left sided diaphragmatic hernia with fundus of stomach and spleen in the chest.      

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Incidental Diaphragmatic Hernia: 2

A D V E R T I S E M E N T

   
 

The adhesions to the edges of the defect were lysed and the stomach and spleen reduced into the abdomen. The edges of the defect are shown.       

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Incidental Diaphragmatic Hernia: 3

A D V E R T I S E M E N T

   
 

The defect was repaired primarily with #1 non-absorbable braided sutures and a left chest tube was placed. Post-operatively, additional history was obtained of a left chest stab wound 20 years previously with pneumothorax treated with chest tube drainage (see discussion.) The patient had been asymptomatic in the intervening time.     

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This page was last modified on 5/14/2007.