The role of laparoscopy in the diagnosis and treatment of missed diaphragmatic rupture

Background: Diaphragmatic rupture is one of the most commonly missed injuri es in trauma cases. Traditionally, laparotomy or thoracotomy has been the t reatment of choice for this condition. Methods: During the last 2 years, we treated three patients laparoscopicall y to address neglected diaphragmatic ruptures that caused herniation of the intraabdominal contents. Results: In all three cases, laparoscopy succeeded in identifying the diaph ragmatic defect, so that the herniated viscera could be released and the de fect repaired primarily or with a prosthesis. The intraoperative and the po stoperative courses were uneventful; there were no significant complication s. Conclusion: Laparoscopy has an important role in the surgical treatment of missed diaphragmatic ruptures.