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Table 1 Review of literature showing demographics data, diagnosis and treatment

From: Emergency surgery due to diaphragmatic hernia: case series and review

Authors,

references

Number of patient, sex, age (years)

Aetiology

Diagnosis

Treatment

Type of hernia

Herniated organs

Lu J et al. Medicine 2016 [41]

1, M, 51

Traffic accident

Barium enema CT scan

Splenectomy

Left hemi diaphragm

Splenic flexure of the colon

1, M, 45

Traffic accident

Chest X-ray, gastrografin contrast

Splenectomy

Left hemi diaphragm

Stomach and small bowel

1, M, 47

Traffic accident

Chest X-ray, gastrografin contrast

Splenectomy

Left hemi diaphragm

Stomach and omentum

1, M, 30

Traffic accident

Chest X-ray, Gastrografin contrast

Nonoperative treatment

Left hemi diaphragm

Stomach and omentum

1, M, 33

Traffic accident

Chest X-ray, gastrografin contrast

Nonoperative treatment

Left hemi diaphragm

Stomach and omentum

1, M, 29

Penetrating injury

Chest X-ray, gastrografin contrast

Nonoperative treatment

Left hemi diaphragm

Stomach and omentum

Manabu Harada, Int J Surg Case Rep. 2016 [42]

1, M, 78

Bochdalek hernia

Chest radiography and computed tomography

Laparoscopic Primary closure

Left hemi diaphragm

Omentum, transverse colon, and small intestine

De la Cour CD; Ugeskr Laeger. 2016 [43]

1, F, 27

Partum

Chest radiography and computed tomography

Primary closure

Left hemi diaphragm

 

Razi K; J Surg Case Rep. 2016 [44]

1, F, 83

Morgagni hernia

Chest radiography and computed tomography

Mesh closure

Left hemi diaphragm

Transverse colon, greater curvature of the stomach and a partial gastric volvulus

Manson HJ Ann R Coll Surg Engl. 2016 [45]

1, F, 30

Bochdalek hernia

Chest radiography and computed tomography

Total gastrectomy with primary Roux-en-Y reconstruction, splenectomy and insertion of a feeding jejunostomy

Left hemi diaphragm

Gangrenous stomach and spleen, cardiac arrest

Massloom HS; N Am J Med Sci. 2016. [46]

1, M, 50

Bochdalek hernia

Computed tomography

Laparotomy and thoracotomy for repairing of defect

Left hemi diaphragm

Bowel

Kumar, J Surg Case Rep. 2016 [47]

1, M, 80

Morgagni hernia

Computed tomography

Laparotomy primary suture

Left hemi diaphragm

Gastric outlet obstruction

Manipadam JMJ Clin Diagn Res. 2016 [48]

1, M, 23

Bochdalek hernia

Chest X-ray

Laparotomy, sleeve resection of the gangrenous portion of the stomach

Left hemi diaphragm

Organoaxial volvulus of the stomach

Harada M, Int J Surg Case Rep. 2016 [49]

1, M, 78

Bochdalek hernia

Chest radiography and computed tomography

laparoscopic repair with primary closure

Left hemi diaphragm

Omentum, transverse colon, and small intestine

Siow SL; J Med Case Rep. 2016 [50]

1, M, 32

Traffic accident

Computed tomographic scan

Laparoscopic surgery with synthetic mesh repair

Left hemi diaphragm

 

A.L. Andreev JSLS 2010 [51]

1, M, 40

Traffic accident 12

years earlier

CT scan

Laparoscopic primary suture

Left hemi diaphragm

Large intestine and greater omentum and acute colon obstruction

 

1, M, 46

Surgery for a stab wound to the chest with injury to the

heart 5 months before

Chest X-ray

Laparoscopic primary suture

Left hemi diaphragm

Transverse

colonic segment

Bhatt NR,

Trauma Mon. 2016 [52]

1, M, 23

Multitrauma 2 y before

Chest X-ray and CT scan

Laparotomy, adhesiolisis and primary repair

Left hemi diaphragm

Small bowel, omentum and large bowel obstruction

Abdullah M, Stonelake P BMJ case rep 2016 [53]

1, F 65

Trauma

Chest X-ray, CT scan

Emergency operation, laparotomy

Left hemi diaphragm

Perforated colon

Razi K; Journal of Surgical Case Reports, 2016 [54]

1, F, 83

Diaphragmatic Morgagni Hernia

Chest X-ray and CT scan

Laparoscopic

repair with a composite mesh with an absorbable tic fixation on the diaphragm

Left hemi diaphragm

Transverse colon, the greater curvature of the stomach with a partial gastric volvulus

A Wigley J Ann R Coll Surg Engl 2014 [55]

1, F, 72

Traffic accident

    

Atef Mejri Medicine

2015 [56]

1, M, 56

Bochdalek hernia

Chest X-ray, barium studies and CT scan

Primary repair Laparoscopy was converted laparotomy

Left hemi diaphragm

Gastric volvulus

Mahmut Tokur

Ulus Travma Acil Cerrahi Derg, July 2015 [57]

1, F, 27

Congenital DH

Chest X-ray, CT scan

Thoracotomy, primary repair

Left hemi diaphragm

Gastro thorax

Topuz Mustafa

Ulus Travma Acil Cerrahi Derg. 2014 [58]

1, F, 55

Traffic accident

Chest X-ray, CT scan

Laparotomy primary repair

Right hemi diaphragm

Liver causing mechanic compression on ventricle

Moussa G

Ann R Coll Surg Engl. 2014 [17]

1, F, 65

Previous history of pericardial window fenestration and sarcoidosis

Chest X-ray, CT scan

Laparoscopy, mesh repair

Right hemi diaphragm

Left lobe of liver, stomach and colon

Nakamura T, Ulus Travma Acil Cerrahi Derg. 2014 [18]

1, M, 81

History of HCC treated with Radiofrequency ablation

Chest US, CT scan

Laparotomy, primary hernia repair, small bowel resection

Right hemi diaphragm

Liver, incarcerated small bowel

Haratake Naoki

Surgery today 2015 [59]

1, F, 50

 

CT scan

Laparotomy, primary hernia repair

Right hemi diaphragm

Heterotopic endometriosis in a patient with Chilaiditi syndrome

Gali BM, Niger J Med. 2014 [60]

1, M, 28

Penetrating injury years before

CT scan

Laparotomy, primary repair

Left hemi diaphragm

Bowel

Michael Joseph Newman, BMJ Case Rep 2014

[61]

1, M, 25

Bochdalek hernia

Chest X-ray, CT scan

Laparotomy, primary repair, gastric resection

Left hemi diaphragm

Stomach and bowel

Tyagi Sam,

Ann Thorac Surg. 2014 [62]

1, M, 36

Morgagni hernia

Chest X-ray, CT scan

Laparoscopy Gore-Tex fixed with a spiral tacker

Left hemi diaphragm

Omentum and transverse colon

Kurniawan N, Acta Chir Belg. 2013 [32]

1, M, 17

Bochdalek hernia

Chest X-ray, CT scan

Laparoscopy primary sutture

Left hemidiaphragm

Stomach, spleen colon

Ota H

Ann Thorac Cardiovasc Surg. 2014 [63]

1, M, 62

Fall accident

ECO FAST,

Chest X-ray, CT scan

Video assisted mini thoracotomy

Primary suture

Right hemi diaphragm

Hemothorax

G, et al. BMJ Case Rep 2013 [64]

1, M, 60

Fall

Chest X-ray, CT scan

Laparoscopy and laparotomy

Left diaphragm

Stomach, bowel and spleen

Sonthalia N, J Emerg Med. 2013 [65]

1, F, 78

Morgagni hernia

Chest X-ray, CT scan, barium studies

Thoracotomy

Left diaphragm

Gastric volvulus

Nayak HK

BMJ Case Rep. 2012 [66]

1, M, 50

Blunt trauma

EGDS, barium studies, CT SCAN

Laparoscopic repair

Left hemi diaphragm

Gastric volvulus and duodenum

Vernadakis S,

Transplant Proc. 2012 [67]

1, F, 46

Liver donor

Chest X-ray, CT scan, barium studies

Laparotomy

Right diaphragm

Bowel

Ngai I,

BMJ Case Rep. 2012 [68]

1, F, 31

Pregnancy

MRI

Nasogastric tube

Left hemi diaphragm

Spleen, bowel, stomach and pancreas

Elangovan A

J Emerg Med. 2013 [69]

1, M, 30

Accident

Chest X-ray and CT scan

Laparoscopy

Left hemi diaphragm

Stomach

Kuppusamy A, Ulus Trauma Acil Cherrai Derg 2012 [70]

1, M, 28

Trauma

CT scan

Thoracotomy

Right hemi diaphragm

Liver

Ismail Okan,

Ulus Travma Acil Cerrahi Derg. 2011 [71]

10 cases,

44,3 y

Trauma

CT scan

7 laparotomy

1 thoracic-abdominal approach

2 thoracic

9 left side

 

Ioannis Baloyiannis

General Thoracic and Cardiovascular Surgery 2011 [72]

1, M, 56

Trauma

 

Laparotomy

  

Vassileva CM

Ann Thorac Cardiovasc Surg. 2012 [73]

1, F, 25

Morgagni hernia

Chest X-ray, CT scan

Laparoscopic repair

Right hemi diaphragm

Omentum

Agrafiotis AC

Acta Chir Belg. 2011 [74]

1, F, 52

Bochdalek hernia

Chest X-ray, CT scan

Laparoscopic approach, and mini laparotomy prosthetic polypropylene mesh

Left hemi diaphragm

Small bowel loops and the right colon

Tan K K, Singapore Med J 2009 [75]

14, median age 38 y

Trauma

Chest X Ray, CT Scan, RMN

Laparotomy, thoracotomy or VATS

Primary repair (85.7%) patients or patch repair

five (35.7%) right-sided and nine (64.3%) left-sided diaphragmatic ruptures

 

Akhtar K,

Br J Hosp Med (Lond). 2009 [76]

1, M, 27

Bochdalek hernia

Chest X Ray, Upper gastrointestinal endoscopy,

CT scan

Laparoscopy

Goretex dual mesh

Left hemi diaphragm

Small bowel, ascending and transverse colon, and spleen

Ozpolat B,

Ulus Travma Acil Cerrahi Derg. Nov; 2009 [77]

1, M, 52

Tube thoracostomy at the seventh left intercostal

Chest X-ray, MRI

Left standard thoracotomy, primary suture

Left hemi diaphragm

Omentum

Altinkaya N Hernia. 2010 [78]

12 patients

mean age of 60 years,

ten were female.

Morgagni hernia

CT scan

Six patients had surgery. 1 emergency surgery for hernia, 2 laparoscopic hernia repair, 3 trans-abdominal repair and 1 transthoracic repair

Right hemi diaphragm

Omentum and colon

Syed Murfad Peer, Int J Surg. 2009 [79]

2496 patients25 (86%) males4 (14%) females mean age 33.6 y

Trauma

Chest X-ray diagnostic in 20 (69%) patients CT scan in 4 (14%) patients. Intra-operative diagnosis of rupture diaphragm was made in 5 (17%) patients.

29 (1.1%) underwent to surgery

20 thoracotomy (69%)

8 laparotomy (27.5%)

1 Thoracoabdominal approach (3.5%)

Right defect: 6

left defect:23

 

Sung HY

J Korean Med Sci. 2009 [80]

1, F, 49

Congenital hernia

Chest radiography

Thoracotomy

Left hemi diaphragm

Stomach, spleen, splenic flexure of the colon bowel loops

Ouazzani A

Acta Chir Belg. 2009

[81]

1, M, 24

Trauma

Chest X-ray computed tomography

Laparoscopically, with mesh

Left diaphragm

Stomach

Kavanagh D

Acta Chir Belg. 2008 [82]

1, M, 76

Bochdalek hernia

Chest radiograph and computed tomogram

Laparotomy, primary repair

Right diaphragm

Strangulation of a portion of transverse colon

Yeh-Huang Hung; J Chin Med Assoc. 2008 [83]

1, M, 74

1, F, 75

Bochdalek hernia

Bochdalek hernias

Chest X-ray CT scan

MRI

Laparotomy

Transthoracic repair

Left diaphragm

Right diaphragm

Intestinal obstruction

Small and large bowels

Sano A

Surg Today. 2008 [16]

1, F, 25

Diaphragm hernia during pregnancy

Chest radiograph and computed tomography

Emergency caesarean section

sutures and a Gore-Tex sheet

Left diaphragm

Bowel loop

Gourgiotis S, Turkish Journal of Trauma & Emergency Surgery 2008 [84]

1, M, 25

Trauma

Chest X-ray

CT scan

Laparoscopic primary repair

Left diaphragm

 

Walchalk LR, J Emerg Med. 2010 [85]

1, F, 57

Trauma

    

Mohammadhosseini B, J Coll Physicians Surg Pak. 2008 [86]

1, M

Bochdalek hernia

    

Boyce S, Obes Surg. 2008 [87]

 

Diaphragmatic hernia post surgery

CT of the chest and abdomen

Laparotomy an repair of hernia

Left diaphragmatic hernia

Ischemic small bowel

Tsuboi K, Surg Today. 2008 [88]

1, M, 50

16 months after surgery

Computed tomography of the chest

Laparotomy

Left diaphragmatic hernia

Stomach had herniated into the thoracic cavity

Vogelaar Obes Surg. 2008 [89]

1, F, 37

Six months after gastric banding

Chest X-ray computed tomography scan

Laparotomy

Left diaphragm

Intra thoracic stomach distended, rotated, and perforated at the orifice of the hernia

Young-Shun Wu; Am J Emerg Med. 2008 [90]

 

History of left-sided upper abdominal blunt injury 2 months before

CT scan

Thoracotomy and primary repair

Left traumatic diaphragm rupture

 

Igai H, Y Gen Thorac Cardiovasc Surg. 2007 [91]

1, M, 48

Trauma

Chest X-ray, CT scan

 

Right diaphragm rupture

Hepatothorax

Rifki Jai S Arch Gynecol Obstet. 2007 [92]

1, F, 27

32-week gestation

no history of trauma

Chest X-ray

CT scan

Emergency laparotomy

Left hemi diaphragm.

Stomach, transverse colon and greater omentum herniated in the left hemithorax

Rout S Hernia. 2007

[93]

1, F, 35

Bochdalek hernias

Chest X-ray

CT scan

Emergency laparotomy defect was repaired using non-absorbable sutures

Right-sided Bochdalek hernia

Colon

Campbell AS Hernia. 2007 [94]

1, M, 85

 

Chest X-ray CT scan

Emergency laparotomy identified a massive diaphragmatic defect which was not amenable to primary closure. A colopexy procedure was performed

Left hemi diaphragm.

Diaphragmatic herniation of bowel

Testini M Surg Today. 2006 [10]

1, M, 51

Left splenopancreatectomy

4 years earlier

Chest X-ray, CT scan, MRI

Left thoracotomy

Left hemi diaphragm

Stomach

Luu TD, Ann Thorac Surg 2006 [95]

1, F, 34

33 weeks’ gestation

Chest roentgenogram, CT scan, barium study Esophagoscopy

the patient went into preterm labour and had a spontaneous vaginal delivery of a healthy new-born at 34 weeks’ gestation. left thoracotomy

Left hemi diaphragm

Necrotic stomach

Iso Y., Hernia 2006

[96]

1, F, 81

Morgagni’s hernia

Chest X-ray

The diaphragm defect was sutured first, and partial resection of the transverse colon

Right thorax

transverse colon

Eglinton T, ANZ J Surg. 2006 Jul [97]

3 cases

During third trimester of pregnancy

Chest X-ray

Laparotomy and thoracotomy in one case. Delivery was by Caesarean section at the time of emergency surgery

  

Barbetakis N, World J Gastroenter ol. 2006 Apr 21 [98]

1, F, 31

Bochdalek hernias during pregnancy (23-week gestation)

Chest X-ray, chest ultrasound

Left thoraco- abdominal incision, segmental resection of the involved portion of large bowel. The diaphragmatic defect was repaired with interrupted sutures

Left hemi thorax

Strangulated Right and transverse colon, necrotic the greater omentum and stomach

Barret J, J Emerg Med. 2006 [99]

1,M, 50

Trauma

Electrocardiogram and CT scan

 

Left hemi thorax and pericardium

 

Abboud B, J Med Liban. 2004 [100]

1 M

Trauma

Chest X-ray, exploratory laparotomy

Laparotomy, colectomy resection of ileum with anastomosis

left hemi thorax

Transverse colon and a proximal small bowel

Hsu YP, Hepatogastroenterology. 2005 [101]

78 patients

Trauma

Chest roentgenogram

Only 20% of elderly patients were operated on within 24 h of trauma, 87% of young patients

  

P Ransom Emerg Med J 2005 [102]

1, M, 21

Trauma

Chest radiograph, ultrasound, oesophago-gastro- duodenoscopy

Thoracotomy

Left diaphragm

Stomach and a loop of colon had herniated through a 6 cm defect

Tiberio GA Acta Chir Belg. 2005 Feb [103]

33 p

Blunt (22 patients) or penetrating injury

Chest X-ray, CT scan

Laparotomy

  

Barakat MJ, BMC Surg. 2005 [19]

1, F, 43

CDH in Marfan’s syndrome

Chest X-ray, CT scan

Laparoscopy

Right hemi diaphragm

Perforated gangrenous appendix

Gupta V Eur J Emerg Med. 2005 [104]

1, M, 43

Spontaneous rupture

CT scan

 

Left hemi diaphragm

 

Kara E Ann Acad Med Singapore 2004 [105]

1, M, 28

Trauma

Chest X-ray, CT scan

Left thoracotomy

Left hemi diaphragm

Gastric fundus

Sirbu H Hernia. 2005 [106]

1, M, 67

Trauma

CT scan

Laparotomy and right thoracotomy

Delayed bilateral diaphragmatic ruptures

 

Dalton AM Emerg Med J. 2004 [107]

1, M, 43

Bochdalek hernia

Chest radiograph

Thoracotomy

Left hemi thorax

Stomach, transverse colon, and spleen in to the chest.

Niwa T Respiration. 2003 [108]

1, F, 53

Bochdalek hernia

Chest X-ray

Thoracotomy

Left hemithorax

Stomach and greater omentum

Genc MR,

Obstet Ginecol 2003 [109]

1, M, 29

Bochdalek hernia during pregnancy

Chest X-ray, CT scan

Antepartum repair

Left hemithorax

Bowel obruction

Sato M, Jpn J Thorac Cardiovasc Surg. 2002 [110]

1, M, 57

Traffic accident

Chest X-ray, CT scan, MRI

Toracoscopy

Right hemidiaphragm

Liver

Guven H, Acta CHir Belg 2002 [111]

2 cases

Morgagni hernia

   

Bowel perforation

Upper gastrointestinal bleeding

Kanazawa A, Surg Today 2002 [112]

1 F 63 y

Bochdalek hernia

Chest X-ray, CT scan,

Thoraco-Laparotomy

Primary suture

Right hemidiaphragm

Colon and right kidney

Fisichella PM, Ann Ital CHIR 2001 [113]

1 F 55 y

Bochdalek hernia

Computed tomography

Thoracotomy and laparotomy

Right hemidiaphragm

Liver intestinal maloration

Bergeron E, J Trauma 2002 [15]

160 cases

Trauma

    

Carreno G, Surg Endosc 2001 [114]

1, M, 52

Bochdalek hernia

CT scan

Laparoscopic approach

Left hemi thorax

Colon and volvulated stomach

Prieto Nieto I, Acta chir Belg 2001 [115]

1, M, 36

8 months after trauma

CT scan

Laparotomy, repair of defect, gastric perforation were closed

Left hemi diaphragm

Gastric incarceration and perforation

Nursal TZ, Hernia 2001 [116]

26 cases

Trauma

Chest X-ray, CT scan,

92% Primary repair

92% left hemi diaphragm

31.8% stomach

27,2 colon

Bujanda L, J Clin Gastroenterol 2001 [117]

1

Bochdalek hernia

  

Left hemi diaphragm

Gastric volvulus

Pross M, J Laparoendosc Adv Surg Tech A 2000 [118]

1, M, 20

Trauma

Diagnostic laparoscopy

Laparoscopy primary repair

Left hemi diaphragm

Stomach

Saito Y, Surg Today 2000 [119]

1, M, 51

3 years after pleuropneumectomy for mesotelioma

 

Laparotomy

Left hemi thorax

Ulcer of stomach, which was displaced into the thorax, had perforated aorta

De Waele JJ, J Accid Emerg Med 1999 [120]

1, M, 45

Trauma

Chest X-ray, Chest tube; ultrasound,

Laparotomy, resection of spleen

Left hemi thorax

Spleen completely disrupted

Colliver C, J Trauma 1997 [121]

1, M, 80

Trauma

Echocardiograph, ultrasonography

 

Left hemi diaphragm

Stomach Intrapericardial hernia

Zantut LF, Rev Paul Med 1993 [122]

1, M, 33

Trauma

Chest X-Ray, liver scintigraphy, CT scan, MRI, diagnostic laparoscopy

Laparoscopy

Bilateral diaphragmatic rupture

 

Allen MS, J Thorac Cardiovasc Surg 1993 [123]

147 cases

5 emergency setting

 

Chest X-ray CT scan

 

Left hemi diaphragm

Stomach

Girzadas DV Jr

Ann Emerg Med. 1991 [124]

1, F, 71

Trauma

Chest radiograph

 

Pericardial sac

Omentum and transverse colon

Thomas S

Jpn J Surg. 1991 [125]

2 cases

Bochdalek hernia

X-ray of the chest and contrast studies of the gastrointestinal tract

Laparotomy

Left hemi diaphragm

Intestinal obstruction

Bush CA,

South Med J 1990 [126]

2 cases

Trauma

Chest X-ray, barium studies of the gastrointestinal tract, CT scans, ultrasonography, laparoscopy, and radionuclide scanning

Laparoscopy

Left hemi diaphragm

Intestinal obstruction

Feliciano DV, J Trauma 1988 [127]

16 cases

Penetrating trauma

Chest X-ray

Laparotomy

  

Chidamdaram M

Thorac Cardiovasc Surg. 1988 [128]

1, M, 32

Trauma

Chest X-ray

Thoracotomy

Left hemi diaphragm

Stomach

Symbas PN, Ann Thorac Surg 1986 [129]

194 cases

Trauma

Chest X-ray, barium studies exploratory laparotomy

Laparotomy

Primary repair

In a case Prolene mesh

  

Saber WL, J Emerg Med 1986 [130]

111 cases

8 emergency surgery

Trauma

Chest X-ray

 

7 left

1 right hemi diaphragm

 

Gardezi SA, J Pak Med Assoc 1986 [131]

2 cases

1, M, 43

Bochdalek hernia

Chest X-ray

Laparotomy

Left hemi diaphragm

Transverse colon and splenic flexure

1 M 26 y

CDH

Chest X-ray

Laparotomy

Left hemi diaphragm

Greater curvature of stomach, a small part of jejunum, left part of trans­verse colon and greater omentum

Brown GL, Ann Thorac Surg 1985 [132]

41 cases

Trauma

Chest X-ray

23 laparotomy, 13 thoracotomy, 5 combined

29 Left,

14 Right-sided, hemi diaphragm.

 

Clark DE, Surgery 1983 [133]

10 cases

median age 40

Trauma

Chest X-ray

 

Left hemi diaphragm

 
  1. M male, F female Y years