• C Diven and R Latifi.
• Division of Trauma, Critical Care and Emergency Surgery, Department of Surgery, University of Arizona, 1501 N. Campbell Avenue, Tucson, AZ, 85724, USA.
• Eur J Trauma Emerg S. 2011 Dec 1;37(6):665-8.

IntroductionTraumatic diaphragmatic rupture is a relatively uncommon occurrence, with an incidence of 0.8-5% reported in the literature. The reported percentage of missed diaphragmatic injuries that were discovered later ranges from 12 to 66%. Herniation of the liver through the right diaphragm has been reported in the literature after liver transplantation, and in trauma populations.Materials And MethodsHere, we report a case of late identification of partial liver herniation into the right chest (8 years post initial injury), due to a recent motor vehicle crash. Thought to be suffering from an acute injury, the patient was taken to the operating room and a laparoscopically assisted mini-thoracotomy was performed. An old diaphragmatic injury was found intraoperatively; laparoscopically assisted mini-thoracotomy was used to repair the diaphragm, and the liver was returned into the abdomen.ConclusionRight-sided diaphragmatic laceration, if diagnosed at the time of injury, may be repaired with the minimally invasive technique we describe here.

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