We report a case of diaphragmatic hernia complicated by diaphragmatic resection. A 71-year-old male underwent lower lobectomy of the left lung for squamous cell carcinoma. The invaded diaphragm was resected, involving an area of 5.2 × 4.5 cm, and closed with interrupted direct sutures. On the fourth postoperative day he complained of nausea and appetite loss, and a chest film on the next day showed a markedly dilated stomach in the left hemithorax. Computed tomography revealed that the diaphragm was ruptured and the stomach with omentum had herniated into the left thoracic cavity. Emergent thoracotomy was performed, revealing that the diaphragm had partially split along the suture line, and the stomach and omentum without ischemic change were incarcerated. After hernia reduction, the diaphragmatic defect was repaired with a monofilament polypropylene mesh patch. No recurrent sign of the diaphragmatic hernia was seen for 13 months after the operation. We should be careful when repairing with direct sutures after diaphragmatic resection.
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