Hernia of the diaphragm with gastric ulcer and volvulus: an unusual complication after diaphragmatic resection by VATS.

We present a 45-year-old female patient who developed diaphragmatic rupture and secondary hernia following a diaphragmatic resection for a diaphragmatic abnormality with spontaneous pneumothorax performed by endoscopic stapling in video-assisted thoracoscopic surgery (VATS). This complication can be avoided by careful direct repair of the diaphragmatic incision in addition to endoscopic stapling.