J Minim Invasive Surg.  2020 Dec;23(4):197-200. 10.7602/jmis.2020.23.4.197.

Diaphragmatic Hernia with Gastric Volvulus and Complete Gastric Outlet Obstruction

• Al-Masari H
• Nofal H
• Majdalawi R
• Ainawi R
• Alwahedi A
• Mahdi T

• KMID: 2509551
• DOI: http://doi.org/10.7602/jmis.2020.23.4.197

Abstract

A combination of Cytoreductive surgery (CRS) along with hyperthermic intraperitoneal chemotherapy (HIPEC) considers a crucial approach in treating designated patients with alimentary and gynecological malignancies with the involvement of the peritoneal cavity. The foremost frequent surgical complications are leakage, digestive perforations, fistulas, intestinal obstruction, abscess, and peripancreatitis. This report presents a case of a patient with a late acquired herniation of guts through the diaphragm after CRS and HIPEC that were already done 6 months back. A 26 -year- old male previously treated with CRS and HIPEC for testicular mesothelioma with peritoneal involvement, was admitted to our unit with the diagnosis of gastric outlet obstruction. His CT scan illustrated a left diaphragmatic hernia involving the stomach and splenocolic flexure. Each denudation of the diaphragmatic serosa throughout CRS which typically occurs during the surgical operation in a combination of the HIPEC heat can explain such complication. The herniation is extremely uncommonly diagnosed after CRS and HIPEC. Surgical techniques for hernia repair can be done by direct suturing of the defect or closure with artificial or biological tissue, each technique is a potential surgical technique for repair with reliable long-run results.

Keyword

Diaphragmatic hernia; HIPEC; Cytoreductive surgery