PMC4573600_01
Case 1. (A and B) CT coronal plane (A) and sagittal plane (B) with greater omentum, small bowel, colon and a portion of the liver in the right hemithorax. (C) Thoracotomy in the right 7th intercostal space with extrusion bowel. (D) Chest X-ray on postoperative day 30 showing adequate bilateral lung expansion.
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Chest tomography confirmed a right diaphragmatic hernia (Fig. 1A and B). The surgery was performed with two incisions: an anterolateral right thoracic incision at the seventh intercostal space, and a midline abdominal incision (Fig. 1C). He was discharged from the ICU on postoperative day 4, and discharged from the hospital, on postoperative day 12 (Fig. 1D).
PMC4573600_02
Case 2. (A and B) CT coronal plane (A) and sagittal plane (B) with greater omentum, stomach, small bowel and colon in the left hemithorax. (C) Thoracotomy in the left 7th intercostal space with extrusion of bowel. (D) Chest X-ray on postoperative day 20 showing bilateral adequate lung expansion.
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Chest tomography confirmed a left diaphragmatic hernia (Fig. 2A and B). The surgery was performed with two incisions: an anterolateral left thoracic incision at the seventh intercostal space (Fig. 2C), and a midline abdominal supraumbilical incision. He was discharged from the ICU on postoperative day 3 and discharged from the hospital on postoperative day 8 (Fig. 2D).
PMC4573600_03
Case 3. (A and B) CT coronal plane (A) and sagittal plane (B) with greater omentum, stomach, small bowel, and colon in the left hemithorax associated with diaphragm eventration. (C) Thoracotomy in the left 7th intercostal space and midline laparotomy. (D) Chest X-ray 0n postoperative day 14 showing appropriate bilateral lung expansion.
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Chest tomography confirmed a left diaphragmatic hernia (Fig. 3A and B). The surgery was performed by two incisions: an anterolateral left thoracic incision at the seventh intercostal space, and a midline abdominal supraumbilical incision (Fig. 3C). He was discharged from the ICU on the postoperative day 2and discharged from the hospital, on postoperative day 7 (Fig. 3D).
PMC4573600_04
Case 4. (A and B) CT coronal plane (A) and sagittal plane (B) with greater omentum, stomach, small bowel, and colon in the left hemithorax. (C) 12 cm hernial ring image, the arrows indicate the edges of the lesion. (D) Chest X-ray on postoperative day 30 showing adequate bilateral lung expansion.
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Chest tomography confirmed a left diaphragmatic hernia (Fig. 4A and B). Exploration of the thoracic cavity revealed a 12 inch annular diaphragmatic defect (Fig. 4C), which allowed passage of a portion of the colon and greater omentum, as well as portions of the stomach and small bowel. He was discharged from the ICU on the first postoperative day and discharged from the hospital, on the seventh postoperative day (Fig. 4D).