{"paper_id":"cec58d95-ce57-400c-a482-8ad56fb00c3e","body_text":"Abstract\nA 50-year-old Japanese female was admitted to our hospital because of ileus due to Chilaiditi syndrome. Her symptoms did not improve with conservative therapy, so chest and abdominal computed tomography (CT) was performed on the fifth day after hospital admission. A diagnosis of incarceration of a right diaphragmatic hernia was established in the coronal view of CT, and emergency surgery was performed. A dilated loop of small intestine was seen in the right thoracic cavity, which was strangulated by the 2-cm defect in the diaphragm. Primary closure of the diaphragm was performed. Approximately 80 cm of the terminal ileum showed obvious ischemic changes, and it was cut and reconstructed. Postoperatively, the patient made an uneventful recovery and was discharged on the 15th postoperative day. A histological examination of the specimen of the diaphragm around the hernia orifice showed the presence of a small cystiform glandular system with hemorrhage and congestion. These findings indicated that heterotopic endometriosis was present in the diaphragm. This report describes the first known case of right diaphragmatic hernia secondary to heterotopic endometriosis in a patient with Chilaiditi syndrome. The clinical course and management of affected patients and a literature review of these three unusual conditions are discussed.\nReferences\nNewman BM, Afshani E, Karp MP, Jewett TC Jr, Cooney DR. Presentation of congenital diaphragmatic hernia past the neonatal period. Arch Surg. 1986;121:813–6.\nHanna WC, Ferri LE, Fata P, Razek T, Mulder DS. The current status of traumatic diaphragmatic injury: lessons learned from 105 patients over 13 years. Ann Thorac Surg. 2008;85:1044–8.\nSoufi M, Meillat H, Le Treut YP. Right diaphragmatic iatrogenic hernia after laparoscopic fenestration of a liver cyst: report of a case and review of the literature. World J Emerg Surg. 2013;8:2.\nChatra PS. Thoracic endometriosis: a case report. J Radiol Case Rep. 2012;6:25–30.\nCooper MJ, Russell P, Gallagher PJ. Diaphragmatic endometriosis. Med J Aust. 1999;171:142–3.\nConflict of interest\nNaoki Haratake and co-authors have no conflicts of interest.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nHaratake, N., Yamazaki, K. & Shikada, Y. Diaphragmatic hernia caused by heterotopic endometriosis in Chilaiditi syndrome: report of a case. Surg Today 45, 1194–1196 (2015). https://doi.org/10.1007/s00595-014-1001-6\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00595-014-1001-6","source_license":"CC0","license_restricted":false}