{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T16:34:03Z","timestamp":1790094843429,"version":"4.0.1"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T00:00:00Z","timestamp":1595376000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T00:00:00Z","timestamp":1595376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Traumatic diaphragmatic injuries (TDIs) are relatively uncommon and require surgical repair to prevent or address herniation. Three quarters of TDIs are due to blunt thoraco-abdominal trauma. In blunt TDIs, variable clinical presentations and frequent concurrent life-threatening injuries may hinder early recognition and treatment, leading to diagnostic delays, which may result in technically more challenging repairs. Right-sided blunt TDIs are much less common than left-sided ones, are difficult to visualize on imaging studies, are more frequently associated with other potentially lethal injuries, and tend to present more subtly, so that diagnostic delays are more likely.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>We report the diagnosis and elective repair of a large right-sided traumatic diaphragmatic hernia resulting from a distant blunt abdominal injury, describing the techniques used to address the challenges presented by the chronic intrathoracic displacement of the entire liver with the gallbladder, as well as the right side of the colon and part of the duodenum.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Early diagnosis of right-sided TDIs can be especially elusive. The management of delayed diaphragmatic hernias can be challenging, but with meticulous planning and a flexible surgical approach, a repair can be achieved resulting in good recovery and low risk of recurrence.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s40792-020-00941-7","type":"journal-article","created":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T18:03:44Z","timestamp":1595441024000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Total thoracic herniation of the liver: a case of delayed right-sided diaphragmatic hernia after blunt trauma"],"prefix":"10.1186","volume":"6","author":[{"given":"Satish","family":"Kesavaramanujam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C.","family":"Morell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhanush","family":"Harigovind","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandana","family":"Bhimmanapalli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9836-9441","authenticated-orcid":false,"given":"Sebastiano","family":"Cassaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,7,22]]},"reference":[{"key":"941_CR1","doi-asserted-by":"crossref","unstructured":"Sala C, Bonaldi M, Mariani P, Tagliabue F, Novellino L. Right post-traumatic diaphragmatic hernia with liver and intestinal dislocation. J Surg Case Rep [Internet]. 2017 [cited 2020 Mar 19];2017(3). Available from: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5400456\/.","DOI":"10.1093\/jscr\/rjw220"},{"key":"941_CR2","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/1749-7922-4-32","volume":"4","author":"F Rashid","year":"2009","unstructured":"Rashid F, Chakrabarty MM, Singh R, Iftikhar SY. A review on delayed presentation of diaphragmatic rupture. World J Emerg Surg WJES. 2009;4:32.","journal-title":"World J Emerg Surg WJES."},{"issue":"3","key":"941_CR3","first-page":"177","volume":"52","author":"T Chughtai","year":"2009","unstructured":"Chughtai T, Ali S, Sharkey P, Lins M, Rizoli S. Update on managing diaphragmatic rupture in blunt trauma: a review of 208 consecutive cases. Can J Surg. 2009;52(3):177\u201381.","journal-title":"Can J Surg."},{"key":"941_CR4","first-page":"1167","volume-title":"Current Surgical Therapy","author":"Management of Diaphragmatic Injuries","year":"2020","unstructured":"Management of Diaphragmatic Injuries. In: Cameron AM, Cameron JL, editors. Current Surgical Therapy. 13th ed. Philadelphia: Elsevier; 2020. p. 1167\u201372.","edition":"13"},{"issue":"6","key":"941_CR5","doi-asserted-by":"publisher","first-page":"1082","DOI":"10.1016\/j.ejcts.2008.01.029","volume":"33","author":"K Turhan","year":"2008","unstructured":"Turhan K, Makay O, Cakan A, Samancilar O, Firat O, Icoz G, et al. Traumatic diaphragmatic rupture: look to see. Eur J Cardiothorac Surg. 2008 Jun 1;33(6):1082\u20135.","journal-title":"Eur J Cardiothorac Surg."},{"key":"941_CR6","doi-asserted-by":"crossref","unstructured":"Zhao L, Han Z, Liu H, Zhang Z, Li S. Delayed traumatic diaphragmatic rupture: diagnosis and surgical treatment. J Thorac Dis. 2019;11(7):2774\u20137.","DOI":"10.21037\/jtd.2019.07.14"},{"issue":"6","key":"941_CR7","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1097\/00000658-199312000-00013","volume":"218","author":"BF Meyers","year":"1993","unstructured":"Meyers BF, McCabe CJ. Traumatic diaphragmatic hernia. Occult marker of serious injury. Ann Surg. 1993;218(6):783\u201390.","journal-title":"Ann Surg."},{"issue":"4","key":"941_CR8","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1177\/000313480707300416","volume":"73","author":"Y Mintz","year":"2007","unstructured":"Mintz Y, Easter DW, Izhar U, Edden Y, Talamini MA, Rivkind AI. Minimally invasive procedures for diagnosis of traumatic right diaphragmatic tears: a method for correct diagnosis in selected patients. Am Surg. 2007;73(4):388\u201392.","journal-title":"Am Surg."},{"key":"941_CR9","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/j.ijscr.2015.07.014","volume":"14","author":"TR de Nadai","year":"2015","unstructured":"de Nadai TR, Lopes JCP, Inaco Cirino CC, Godinho M, Rodrigues AJ, Scarpelini S. Diaphragmatic hernia repair more than four years after severe trauma: four case reports. Int J Surg Case Rep. 2015;14:72\u20136.","journal-title":"Int J Surg Case Rep."},{"key":"941_CR10","unstructured":"Birindelli A, Sartelli M, Di Saverio S, Coccolini F, Ansaloni L, van Ramshorst GH, et al. 2017 update of the WSES guidelines for emergency repair of complicated abdominal wall hernias. World J Emerg Surg WJES [Internet]. 2017 [cited 2020 Mar 22];12. Available from: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5545868\/."},{"issue":"8","key":"941_CR11","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1007\/s11748-009-0418-0","volume":"57","author":"T Mizobuchi","year":"2009","unstructured":"Mizobuchi T, Iwai N, Kohno H, Okada N, Yoshioka T, Ebana H. Delayed diagnosis of traumatic diaphragmatic rupture. Gen Thorac Cardiovasc Surg. 2009;57(8):430\u20132.","journal-title":"Gen Thorac Cardiovasc Surg."},{"issue":"4","key":"941_CR12","first-page":"PD04","volume":"10","author":"GR Katukuri","year":"2016","unstructured":"Katukuri GR, Madireddi J, Agarwal S, Kareem H, Devasia T. Delayed diagnosis of left-sided diaphragmatic hernia in an elderly adult with no history of trauma. J Clin Diagn Res JCDR. 2016;10(4):PD04\u20135.","journal-title":"J Clin Diagn Res JCDR."}],"container-title":["Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-020-00941-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40792-020-00941-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-020-00941-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,21]],"date-time":"2021-07-21T23:22:07Z","timestamp":1626909727000},"score":1,"resource":{"primary":{"URL":"https:\/\/surgicalcasereports.springeropen.com\/articles\/10.1186\/s40792-020-00941-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,22]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["941"],"URL":"https:\/\/doi.org\/10.1186\/s40792-020-00941-7","relation":{},"ISSN":["2198-7793"],"issn-type":[{"value":"2198-7793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,22]]},"assertion":[{"value":"24 April 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 July 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 July 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All the authors have no competing interests to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"178"}}