Diaphragmatic hernia masquerading as a pulmonary metastasis

Iatrogenic injury accounts for the second most common cause of acquired diaphragmatic hernias after penetrating trauma. An increased incidence of these hernias has been observed with the widespread use of laparoscopic surgery. We present the case of a 65-year-old woman who initially underwent sigmoi...

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Bibliographic Details
Published in:Annals of the Royal College of Surgeons of England 2015-03, Vol.97 (2), p.e27-e29
Main Authors: Lodhia, J V, Appiah, S, Tcherveniakov, P, Krysiak, P
Format: Article
Language:English
Subjects:
Abdominal surgery
Adenocarcinoma - pathology
Adenocarcinoma - secondary
Adenocarcinoma - surgery
Aged
Defects
Diagnosis, Differential
Family medical history
Female
Gastric cancer
Hernia, Diaphragmatic - diagnosis
Hernia, Diaphragmatic - etiology
Hernias
Humans
Iatrogenic Disease
Laparoscopy
Liver Neoplasms - secondary
Liver Neoplasms - surgery
Lung cancer
Lung Neoplasms - diagnosis
Metastasis
Online Case report
Ostomy
Sigmoid Neoplasms - pathology
Sigmoid Neoplasms - surgery
Tomography
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Summary:Iatrogenic injury accounts for the second most common cause of acquired diaphragmatic hernias after penetrating trauma. An increased incidence of these hernias has been observed with the widespread use of laparoscopic surgery. We present the case of a 65-year-old woman who initially underwent sigmoid resection for an adenocarcinoma and a subsequent liver resection for metastasis. She was noted to have a left lower lobe pulmonary nodule on surveillance computed tomography, for which she underwent a mini-thoracotomy for a planned resection. At the time of surgery, the pulmonary nodule was discovered to be a diaphragmatic hernia, most probably of iatrogenic origin. We discuss the difficulty in diagnosis given her history and the location of such a lesion.
ISSN:0035-8843
1478-7083
DOI:10.1308/003588414X14055925060758