case_images: PMC11829737_01
case_images: Barium swallow. Voluminous left parahiatal hernia. The entire gastric fundus is herniated in the thoracic cavity (black arrow).
case_images: cureus-0017-00000077548-i01.jpg
case_images: PMC11829737_01_cureus-0017-00000077548-i01.jpg
case_images: FIG1
case_images: The barium swallow showed a large diaphragmatic hernia with the entire gastric fundus located in the left thoracic cavity (Figure 1).
case_images: Thoracic and abdominal CT scan. A. Voluminous left parahiatal diaphragmatic hernia with gastric fundus in the thoracic cavity (yellow arrow). B. Left subcostal diaphragmatic hernia with adipose content (yellow arrow). C. Metal density image in the posterobasal segment of the right lower lobe (green arrow).
case_images: cureus-0017-00000077548-i02.jpg
case_images: PMC11829737_01_cureus-0017-00000077548-i02.jpg
case_images: FIG2
case_images: The CT showed a large left parahiatal diaphragmatic hernia with sliding of the gastric fundus (Figure 2A) and a smaller diaphragmatic defect with adipose content just above the spleen (Figure 2B). A metal density image in the posterobasal segment of the right lower lobe corresponding with the history of previous GSW was also identified (Figure 2C).
case_images: Laparoscopic repair of traumatic diaphragmatic hernia. A. Identification of both diaphragmatic defects: left parahiatal and left subcostal (yellow arrow and circles). B. Diaphragmatic defects closed with interrupted non-absorbable sutures (yellow arrows). C. Reinforcement of the repair with a polytetrafluoroethylene mesh covering both defects.
case_images: cureus-0017-00000077548-i03.jpg
case_images: PMC11829737_01_cureus-0017-00000077548-i03.jpg
case_images: FIG3
case_images: During the exploratory laparoscopy, both diaphragmatic defects were identified: left parahiatal with the gastric fundus and left subcostal with greater omentum (Figure 3A). Both defects were closed with non-absorbable interrupted sutures (i.e., Polyester 2-0) (Figure 3B). A 15x20 cm reinforcing mesh of polytetrafluoroethylene (a synthetic fluoropolymer of tetrafluoroethylene that has numerous applications because it is chemically inert) was then placed covering both defects, which was fixed to the diaphragm with non-absorbable interrupted sutures (Figure 3C).