Two cases of diaphragmatic hernia (congenital and post-traumatic) primarily treated by laparotomic access: critical appraisal of operative strategy

Abstract

We report a case of congenital diaphragmatic hernia and a case of a post – traumatic one. Both of them have been treated by a laparoscopic access,  but we think that for post – traumatic hernia particularly if delayed, thoracotomy could represent a better surgical approch. This is because if the abdominal viscera remain for long time into the pleural cavity, important adhesions develop into the pleural space so that reducing herniated viscera into abdomen could reveal difficult. Moreover if a tract of herniated bowel has to be resected because of necrosis, the surgeon can manage better the pleural cavity via a thoracotomic access, because adequate cleaning and washing can be performed.