Tag Archives: diaphragm

PUBLISHED: Exploratory Laparotomy for Bowel Obstruction with Primary Repair of Two Diaphragmatic Hernias

Exploratory Laparotomy for Bowel Obstruction with Primary Repair of Two Diaphragmatic Hernias
Katherine H. Albutt, MD
Massachusetts General Hospital

A diaphragmatic hernia (DH) is characterized by protrusion of abdominal organs into the chest cavity through an opening in the diaphragm. A sliding or paraesophageal hernia is the most prevalent type, characterized by its occurrence near the esophageal hiatus. Typically present since birth, it can also develop later in life, occasionally arising as a result of severe trauma or iatrogenic injury. Less often, congenital DHs protrude through posterolateral or substernal diaphragmatic defects, referred to as Bochdalek and Morgagni hernias, respectively.

DH can remain asymptomatic and is commonly detected as an incidental finding during evaluation for other medical issues. Hiatal hernias differ from abdominal wall hernias in that they are influenced by the constant motion of the diaphragm, which exerts continuous friction and pressure changes on the esophagus and the stomach. As a result, hiatal hernias have a higher likelihood of recurrence following surgical correction in comparison to abdominal hernias.

This is the case of an exploratory laparotomy for bowel obstruction and primary pledgeted repair of two diaphragmatic hernias.

PREPRINT RELEASE: Laparoscopic Paraesophageal Hernia Repair

0126-blog-shotLaparoscopic Paraesophageal Hernia Repair
David Rattner MD
Chief of Gastrointestinal and General Surgery
Massachusetts General Hospital

Dr. Rattner tackles a problematic paraesophageal hernia, systematically retracting the stomach into the abdominal cavity. He finishes the procedure by performing both a toupet fundoplication and gastropexy.