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Eur J Cardiothorac Surg 2004;25:1121
© 2004 Elsevier Science NL

Images in cardio-thoracic surgery

Right diaphragmatic rupture and hepatic hernia: a rare late sequela of thoracic trauma

Christophoros Kotoulasa*, Elefterios Chouliarasb, Panagiotis Siarapisc, Konstantinos Nisotakisa

a Department of General Thoracic Surgery, 401 General Military Hospital of Athens, Athens, Greece
b Department of Anesthesiology, 401 General Military Hospital of Athens, Athens, Greece
c Department of Radiology, 401 General Military Hospital of Athens, Athens, Greece

Received 1 December 2003; received in revised form 26 January 2004; accepted 4 February 2004.

* Corresponding author. Address: 70c Bakoyanni str, Vrilissia, GR-15235 Athens, Greece. Tel./fax: +30-1-6081367
e-mail: chrkotoulas{at}hol.gr

Key Words: Blunt thoracic trauma • Hepatic hernia • Helical CT-scan

A 20-year-old male presented with partial elevation of the right hemidiaphragm, as an accidental finding in a chest X-ray. His past medical history included a blunt thoracic trauma with rib fractures and hemopneumothorax, 16 months ago. The diagnosis was achieved by a CT-scan, while the hemidiaphragm was sutured in two layers via a thoracotomy (Figs. 1 and 2) .



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  		Fig. 1. Coronal reformatted images of helical CT-scan show the hepatic hernia of the left lobe.

 


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  		Fig. 2. The 12-cm long laceration of the tendinous portion of the diaphragm and the hernia of the left hepatic lobe were revealed through an anterolateral thoracotomy.

 




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