Laparoscopic Repair of Diaphragmatic Hernia: A Report of Two Adult Cases

The protrusion of abdominal contents into the thoracic cavity through a defect in the diaphragm is known as a diaphragmatic hernia. It can be either congenital or acquired with congenital cases often diagnosed prenatally and repaired shortly after birth. Diagnosing an adult diaphragmatic hernia can be difficult because the condition may stay asymptomatic or exhibit unusual and unrelated symptoms. Acquired diaphragmatic hernias are more common in adults, with trauma, both blunt and penetrating, as the primary cause. High clinical suspicion is essential, and prompt radiological investigation is crucial for accurate diagnosis. Early diagnosis and appropriate surgical intervention are essential for optimal outcomes. In the present article, two cases of adult diaphragmatic hernias are described. The first case presented with herniation of small gut loops into the left hemithorax in a 29-year-old woman. The second case was with a giant diaphragmatic hernia containing the spleen, stomach, small gut, and large gut loops and a part of the liver masquerading as tension pneumothorax in a 30-year-old woman (Gastrospleenothorax). Both cases were diagnosed and managed successfully via laparoscopic repair. This report, along with a review of the literature, highlights the unusual presentation of diaphragmatic hernias in adults and demonstrates the feasibility of laparoscopic repair.