Published: 2020-01-27

Iatrogenic diaphragmatic hernia after laparoscopic gastric band removal: a rare case report

Emília C. Fraga, Cristina P. Camacho, Ana C. Almeida, Maria J. Amaral, João R. Almeida


Iatrogenic diaphragmatic hernia is a rare complication of esophageal and upper abdominal surgery. The use of the gastric band has been an established and popular surgical treatment for morbid obesity. We describe a rare case of a patient who had undergone laparoscopic surgery to remove an adjustable gastric band, who presented 5 months later with an acute intense thoracic pain. The computed tomography scan revealed a diaphragmatic hernia containing the stomach. The patient required emergent laparoscopic surgery to reduce the hernia, repair the defect and resection of the ischemic stomach. In this case report, we discuss the etiology, diagnosis and treatment of this very rare complication of laparoscopic gastric banding removal. 


Strangulated diaphragmatic hernia, Complication of bariatric surgery, Laparoscopic repair of iatrogenic diaphragmatic hernia, Laparoscopic adjustable gastric band

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Dukhno O, Peiser J, Levy I, Ovnat A. Iatrogenic diaphragmatic hernia due to laparoscopic gastric banding. Surg Obes Relat Dis. 2006;2:61-3.

Batmunsky M, Yoffe B, Dukhno O. Laparoscopic repair of postbariatric incarcerated diaphragmatic hernia presenting as large bowel obstruction. Surg Obes Relat Dis. 2015;11(2):15-7.

Boyce S, Burgul R, Pepin F, Shearer C. Late presentation of a diaphragmatic hernia following laparoscopic gastric banding. Obes Surg. 2008;18:1502-4.

Axon PR, Whatling PJ, Dwerryhouse S, Forrester-Wood CP. Strangulated iatrogenic diaphragmatic hernia: a late diagnosed complication. Eur J Cardiothorac Surg. 1995;9:664-6.

Alimoglu O, Eryilmaz R, Sahin M, Ozsoy MS. Delayed traumatic diaphragmatic hernias presenting with strangulation. Hernia. 2004;8:393-6.

Arsalane A, Herman D, Bazelly B. Left strangulated diaphragmatic hernia: an unusual complication of gastric bypass. Rev Pneumol Clin. 2005;61:374-7.

Alfa- Wali M, Leuratti L, Efthimiou E. Diaphragmatic Richter's type of hernia involving the transverse colon after laparoscopic gastric bypass: an unusual complication. Surg Obes Relat Dis. 2013;9:60-2.

Borg CM, Katz- Summercorn A, Adamo M. Acute diaphragmatic herniation as cause of small bowel obstruction after gastric bypass. Surg Obes Relat Dis. 2011;7:6-8.

Suh Y, Hyun Lee J, Jeon H, Kim D, Kim W. Late onset iatrogenic diaphragmatic hernia after laparoscopy-assisted total gastrectomy for gastric cancer. J Gastric Cancer. 2012;12:49-52.

Chevallier JM, Zinzindohoue F, Douard R, Blanche JP, Berta JL, Altman JJ, et al. Complications after laparoscopic adjust- able gastric banding for morbid obesity: experience with 1,000 patients over 7 years. Obes Surg. 2004;14:407-14.