PMC9912997_01
Computed Tomography of the abdomen and pelvis, coronal view demonstrating diffuse distension of bowel loops with a transition point at the right diaphragmatic defect.
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F1
Oral contrast failed to advance past the stomach and a high grade bowel obstruction at a diaphragmatic hernia was identified (Figure 1).
Laparoscopic view of incarcerated bowel through the right diaphragmatic hernia, bowel grasper retracting medially, the right lobe of the liver, and the other grasper dissecting the hernia defect..
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F2
Inspection of the right upper quadrant revealed dilated loops of bowel entering diaphragmatic defect with decompressed small bowel distally (Figure 2).
Intraoperative view of diaphragmatic defect after reduction.
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F3
The hernia defect was then repaired with interrupted polypropylene suture with pledgets (Figure 3).
Postoperative chest X-ray.
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F4
The postoperative chest x-ray revealed a successful repair, and follow-up chest x-ray showed trace pleural effusion with atelectasis but no evidence of pneumothorax (Figure 4).
Three month postoperative chest X-ray.
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F5
Furthermore, a chest x-ray obtained three months postoperatively showed no recurrence (Figure 5).