{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:23:03Z","timestamp":1787836983206,"version":"build-2784847793"},"reference-count":11,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,7,24]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>Right-sided diaphragmatic hernias are rare and often present late due to delayed diagnosis. We report a female in her mid-20s who presented with progressive dyspnoea on exertion and a remote history of blunt trauma in childhood. Imaging revealed a massive right-sided diaphragmatic hernia with herniation of the entire right lobe of the liver, hepatic flexure of the colon and stomach into the right hemithorax. A thoraco-laparoscopic approach was initially planned; however, complete intrathoracic herniation of the liver and severe diaphragmatic atrophy precluded laparoscopic reduction. The patient was successfully managed through a limited thoracoabdominal incision with mesh-based reconstruction of the entire diaphragm. She had an uneventful postoperative recovery with complete re-expansion of the right lung and resolution of symptoms.<\/jats:p>","DOI":"10.1136\/bcr-2026-272361","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:05:14Z","timestamp":1787835914000},"page":"e272361","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Massive right-sided diaphragmatic hernia with intrathoracic liver"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8219-355X","authenticated-orcid":false,"given":"Devender","family":"Singh","sequence":"first","affiliation":[{"name":"Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3770-8276","authenticated-orcid":false,"given":"Palak","family":"Meena","sequence":"additional","affiliation":[{"name":"Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8326-0104","authenticated-orcid":false,"given":"Amarinder Singh","family":"Malhi","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9926-7917","authenticated-orcid":false,"given":"Anshul","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pain Medicine and Critical care, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piyush","family":"Ranjan","sequence":"additional","affiliation":[{"name":"Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"2026082706050518000_19.8.e272361.1","doi-asserted-by":"crossref","DOI":"10.1093\/jscr\/rjaf862","article-title":"Laparoscopic right-sided traumatic diaphragmatic hernia repair: a case report and video vignette","volume":"2025","author":"Cornwell","year":"2025","journal-title":"J Surg Case Rep"},{"key":"2026082706050518000_19.8.e272361.2","doi-asserted-by":"crossref","DOI":"10.1016\/j.tcr.2025.101243","article-title":"Right-sided diaphragmatic hernia with hepatic herniation after blunt trauma: Report of two cases of early diagnosis and treatment","volume":"59","author":"Rocca","year":"2025","journal-title":"Trauma Case Rep"},{"key":"2026082706050518000_19.8.e272361.3","doi-asserted-by":"crossref","DOI":"10.1097\/IA9.0000000000000039","article-title":"The natural history of unrecognized diaphragmatic hernias after blunt trauma: A narrative review and presentation of three clinical cases","volume":"44","author":"Siquini","year":"2024","journal-title":"Il Giornale Di Chirurgia - Journal of the Italian Association of Hospital Surgeons"},{"key":"2026082706050518000_19.8.e272361.4","doi-asserted-by":"crossref","first-page":"365","DOI":"10.47717\/turkjsurg.2023.6271","article-title":"The silent threat: A retrospective study of right-sided traumatic diaphragmatic hernias in a university hospital","volume":"39","author":"Kruger","year":"2023","journal-title":"Turk J Surg"},{"key":"2026082706050518000_19.8.e272361.5","doi-asserted-by":"crossref","DOI":"10.1186\/s40792-020-00941-7","article-title":"Total thoracic herniation of the liver: a case of delayed right-sided diaphragmatic hernia after blunt trauma","volume":"6","author":"Kesavaramanujam","year":"2020","journal-title":"Surg Case Rep"},{"key":"2026082706050518000_19.8.e272361.6","doi-asserted-by":"crossref","first-page":"205","DOI":"10.4103\/jmas.jmas_333_23","article-title":"First ever reported case of right-sided rupture of eventration of the diaphragm: Thoraco-laparoscopic approach","volume":"21","author":"Gupta","year":"2025","journal-title":"J Minim Access Surg"},{"key":"2026082706050518000_19.8.e272361.7","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s13017-017-0134-5","article-title":"Emergency surgery due to diaphragmatic hernia: case series and review","volume":"12","author":"Testini","year":"2017","journal-title":"World J Emerg Surg"},{"key":"2026082706050518000_19.8.e272361.8","doi-asserted-by":"crossref","first-page":"31","DOI":"10.4103\/ijawhs.ijawhs_37_20","article-title":"The laparoscopic repair of giant diaphragmatic hernia with synthetic mesh","volume":"4","author":"Yuan","year":"2021","journal-title":"International Journal of Abdominal Wall and Hernia Surgery"},{"key":"2026082706050518000_19.8.e272361.9","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1055\/s-0034-1394155","article-title":"Biologic versus Synthetic Mesh Reinforcement: What are the Pros and Cons?","volume":"27","author":"FitzGerald","year":"2014","journal-title":"Clin Colon Rectal Surg"},{"key":"2026082706050518000_19.8.e272361.10","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1016\/j.surg.2023.11.013","article-title":"Quality of life measures and cost analysis of biologic versus synthetic mesh for ventral hernia repair: The Preventing Recurrence in Clean and Contaminated Hernias randomized clinical trial","volume":"175","author":"Diab","year":"2024","journal-title":"Surgery"},{"key":"2026082706050518000_19.8.e272361.11","doi-asserted-by":"crossref","DOI":"10.1186\/s12893-025-03151-w","article-title":"Comparative outcomes of synthetic and biological mesh use in laparoscopic inguinal hernia repair: a systematic review and meta-analysis","volume":"25","author":"Romano","year":"2025","journal-title":"BMC Surg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-272361","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:05:16Z","timestamp":1787835916000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-272361"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":11,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,27]]},"published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1136\/bcr-2026-272361"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-272361","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]}}}