LAPAROSCOPIC DIAGNOSIS AND THERAPY IN BLU NT DIAPHRAGMATIC RUPTURE

Diagnosis of blunt diaphragmatic rupture is still a challenging proble m. This injury is generally treated by direct closure of the defect vi a a laparotomy or a thoracotomy. As it occurs frequently in severely t raumatized patients, we wondered whether those patients could benefit from the well-known advantages of minimally invasive surgery. We repor t the records of two patients who underwent laparoscopy for blunt diap hragmatic hernia. In both patients, the hernia was laparoscopically cl osed without opening the abdomen. We did not see any intra- or postope rative complications related to minimally invasive surgery; the postop erative recovery was impressively short. Taking into account the fact that diaphragmatic ruptures are frequently misdiagnosed, we recommend laparoscopy as a useful tool in cases where these injuries may be susp ected. In selected patients, primary closure of the defect may be achi eved within the same laparoscopy so that laparotomy can be avoided.