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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