[The transpleurodiaphragmatic laparoscopic approach of rear dome liver cysts]. / Abordul laparoscopic transpleurodiafragmatic al chistelor hepatice de dom posterior.

The localizations of liver cysts in the posterior hepatic dome (segment VII) and the hydatid cysts in particular, difficult to approach in "conventional" open or laparoscopic surgery, with significant parietal sacrifices and "demolition", requires a secure atypical laparoscopic approaching way, with positive results for both patient and surgeon, with minimal impact, with social and professional reintegration and faster healing. Transpleurodiaphragmatic laparoscopic approach using "Device for aspiration of liver hydatid cyst or ovarian cyst (OSIM 120809/30.04.2008 Patent - Dan Sabau) asociated with the remarcable performances of the fragmentation device for hydatid cyst content (OSIM Patent no. 120810/30.04.2008 - Dan Sabau) is the best way to approach these problems, accessible for surgeons with minimum experience in laparoscopic and thoracic surgery. The relatively low number of cases allows only formulation of preliminary positive conclusions on the method, they will be validated by subsequent results.

Late presentation of a shrapnel wound-induced traumatic intra-thoracic abdominal evisceration, as colon perforation with left faecopneumothorax.

The diaphragmatic hernia is a well recognized and common complication of both the penetrating and blunt thoracoabdominal trauma.The clinical presentation is eather in the acute phase, or later, when it features the symptoms of obstructive complications. The aim of the study is to report a case of delayed presentation of a blast wound with diaphragmatic hernia, complicated by herniation and perforation of the left colonic angle in the pleural cavity. The report highlights the multiple complications following the initial event and the staged management of the case.