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Hernia : the Journal of Hernias and... Oct 2012An adult presentation of congenital diaphragmatic hernia is very rare. Here, we present a rare case report of left-sided central diaphragmatic hernia in an adult....
INTRODUCTION
An adult presentation of congenital diaphragmatic hernia is very rare. Here, we present a rare case report of left-sided central diaphragmatic hernia in an adult. Laparoscopic repair of the hernia was performed with mesh placement.
CASE SUMMARY
A 19-year-old adult man was presented with pain in abdomen and occasional vomiting. X-ray and CT scan thorax was suggestive of diaphragmatic hernia with herniation of stomach. Laparoscopic repair were performed with mesh placement.
DISCUSSION
Central diaphragmatic hernia is rarely seen in adults. Only one such case is reported so far. Successful repair was performed with laparoscopy. Patient recovered well without any postoperative complications.
Topics: Adult; Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Herniorrhaphy; Humans; Laparoscopy; Male; Radiography; Surgical Mesh; Young Adult
PubMed: 21340510
DOI: 10.1007/s10029-011-0800-6 -
The American Surgeon Jul 2018Postoperative iatrogenic diaphragmatic hernias have been reported sparingly after several thoracic and abdominal surgeries. Although rare, a delay in diagnosis can lead...
Postoperative iatrogenic diaphragmatic hernias have been reported sparingly after several thoracic and abdominal surgeries. Although rare, a delay in diagnosis can lead to life-threatening cases of strangulation or perforation, as well as cardiovascular and respiratory insufficiency. This is a case of a 78-year-old female who developed acute obstructive symptoms secondary to herniation of the distal stomach through a defect in the central tendon of the diaphragm. The diaphragmatic defect was presumed to be iatrogenically acquired after Nissen fundoplication one year prior. Other etiologies were not as likely considering that she had never had any trauma to her chest or abdomen and had no history suggestive of a congenital nature for the diaphragmatic hernia. The hernia was successfully decompressed laparoscopically with the stomach having ischemic changes along the greater curvature, necessitating gastric wedge resection. The diaphragmatic defect, which was lengthened to reduce the edematous incarcerated stomach, was repaired primarily. The patient had an uneventful postoperative course. This case highlights the potential complication of incarcerated diaphragmatic hernia after Nissen fundoplication. Late diagnosis of iatrogenic diaphragmatic hernias is frequent because of nonspecific symptoms and surgery is indicated at the time of diagnosis.
Topics: Aged; Female; Fundoplication; Hernia, Diaphragmatic; Humans; Iatrogenic Disease; Treatment Outcome
PubMed: 30064587
DOI: No ID Found -
The Journal of Small Animal Practice Sep 1970
Topics: Animals; Dog Diseases; Dogs; Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Male
PubMed: 5531147
DOI: 10.1111/j.1748-5827.1970.tb05619.x -
Journal of Pediatric Surgery Jan 2012We developed the congenital diaphragmatic hernia congenital prognostic index (CDH-CPI) to incorporate all known prognostic variables into a single composite index to...
PURPOSE
We developed the congenital diaphragmatic hernia congenital prognostic index (CDH-CPI) to incorporate all known prognostic variables into a single composite index to improve prognostic accuracy. The purpose of this study is to examine the ability of the CDH-CPI to predict survival in patients with left-sided congenital diaphragmatic hernia and to determine if the index has a stronger correlation with survival than each of the individual components.
METHODS
A retrospective review of patients with left-sided congenital diaphragmatic hernia between 2004 and 2010 was conducted. Ten prenatal parameters of the CDH-CPI were collected, total score was tabulated, and patients stratified according to total score and survival.
RESULTS
Sixty-four patients with a prenatal diagnosis of left-sided congenital diaphragmatic hernia were identified. Patients with a CDH-CPI score of 8 or higher had a significantly higher survival than patients with a CDH-CPI score of lower than 8. The CDH-CPI has the strongest correlation with survival compared with the individual parameters measured. The CDH-CPI correlates with extracorporeal membrane oxygenation use, and 75% of patients with a score of 5 or lower were placed on extracorporeal membrane oxygenation.
CONCLUSIONS
The CDH-CPI accurately stratifies survival in left-sided congenital diaphragmatic hernia. The amalgamation of 10 prenatal parameters of the CDH-CPI may be a better prenatal predictor than any single prognostic variable currently used.
Topics: Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Humans; Infant, Newborn; Prognosis; Retrospective Studies; Severity of Illness Index; Survival Rate
PubMed: 22244393
DOI: 10.1016/j.jpedsurg.2011.10.020 -
BMJ Case Reports Jun 2017A 4-year-old boy from Syria was evaluated at the emergency department because of an upper airway viral illness. His physical examination showed a significant intensity...
A 4-year-old boy from Syria was evaluated at the emergency department because of an upper airway viral illness. His physical examination showed a significant intensity reduction of all heart sounds in the absence of any other pathological signs. As the child was affected with Down's syndrome and had suffered thoracic and abdominal trauma because of bombardments, a diaphragmatic hernia was immediately suspected and was confirmed through a simple chest X-ray. A careful clinical examination is crucial in refugee children and adolescents, as several medical and surgical disorders could have escaped previously.
Topics: Child, Preschool; Diagnosis, Differential; Emergency Treatment; Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Humans; Italy; Male; Refugees; Syria
PubMed: 28611139
DOI: 10.1136/bcr-2017-220748 -
Journal of the American Veterinary... Jan 2014
Topics: Animals; Cat Diseases; Cats; Hernia, Diaphragmatic; Male; Radiography
PubMed: 24378022
DOI: 10.2460/javma.244.2.157 -
American Journal of Surgery May 1975Symptoms, signs, and definitions of strangulation and incarceration in diaphragmatic herniation are surveyed, and four patients with strangulated diaphragmatic hernia...
Symptoms, signs, and definitions of strangulation and incarceration in diaphragmatic herniation are surveyed, and four patients with strangulated diaphragmatic hernia are reported on. Although the symptoms may be uncharacteristic, the diagnosis is easily made, if kept in mind. X-ray examination of the chest, possibly supplemented by a barium meal, usually indicates the diagnosis. The mortality rate in our series was high, similar to the findings in other series in the literature. Since approximately half of the cases of incarcerated and/or strangulated diaphragmatic hernia are due to overlooked traumatic diaphragmatic rupture, we stress the importance of diagnosing and treating such rupture promptly to reduce the mortality rate. Strangulated diaphragmatic hernia is a clinical entity on the borderline between the fields of thoracic and general surgery. The disorder is often overlooked or improperly treated, possibly because most units have limited experience with this particular phenomenon.
Topics: Adult; Aged; Dyspnea; Female; Fever; Hernia, Diaphragmatic; Hernia, Diaphragmatic, Traumatic; Humans; Intestinal Obstruction; Male; Methods; Middle Aged; Pain; Radiography, Abdominal; Stomach
PubMed: 1130598
DOI: 10.1016/0002-9610(75)90319-0 -
The Surgical Clinics of North America Dec 1971
Review
Topics: Antacids; Diet, Reducing; Esophagogastric Junction; Hernia, Diaphragmatic; Humans
PubMed: 4943122
DOI: 10.1016/s0039-6109(16)39589-5 -
Early Human Development Apr 2012Survivors of congenital diaphragmatic hernia have increased with the introduction of new treatment modalities and have been reported to experience ongoing medical...
INTRODUCTION
Survivors of congenital diaphragmatic hernia have increased with the introduction of new treatment modalities and have been reported to experience ongoing medical morbidity until adulthood.
AIM
To describe the long-term functional impact of congenital diaphragmatic repair on the survivors of a single institution cohort of newborns over a 14-year period.
METHODS
The follow up medical charts of 39 congenital diaphragmatic hernia survivors treated at a tertiary neonatal intensive care unit, from January 1997 to December 2010, were analyzed.
RESULTS
The median age at follow up was 70 (4-162) months. Gastrointestinal sequelae were the most common with 12 (30.7%) patients affected by failure to thrive. Chronic lung disease occurred in 5 (12.8%) patients, neurodevelopmental delay in 5 (12.8%), musculoskeletal sequelae in 6 (15.3%), recurrence of hernia in 4 (10.2%) and 2 (7.6%) were deceased.
CONCLUSION
Congenital diaphragmatic hernia survivors are a group of patients that requires long term periodic follow up in a multidisciplinary setting to provide adequate support and improve their quality of life.
Topics: Adolescent; Child; Child, Preschool; Developmental Disabilities; Female; Follow-Up Studies; Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Humans; Infant; Infant, Newborn; Male; Morbidity; Postoperative Complications; Survivors; Treatment Outcome
PubMed: 21945360
DOI: 10.1016/j.earlhumdev.2011.08.025 -
Acta Paediatrica (Oslo, Norway : 1992) Mar 2011To characterize the clinical manifestations of late-presenting diaphragmatic hernia and its associated anomalies, diagnostic methods and outcomes.
AIM
To characterize the clinical manifestations of late-presenting diaphragmatic hernia and its associated anomalies, diagnostic methods and outcomes.
METHODS
The records of patients aged 1 month-18 years old diagnosed with Bochdalek diaphragmatic hernia from February 1987-June 2008 were reviewed.
RESULTS
Fifteen children (nine boys, six girls) met inclusion criteria. Median age was 1.5 years (range, 38 days-9.9 years). Eleven (73%) had left-sided and four (27%) had right-sided diaphragmatic hernias. Six (40%) patients presented with respiratory symptoms, six (40%) with gastrointestinal symptoms and three (20%) with both. Five (33%) patients had failure to thrive. Six (40%) were diagnosed by chest radiography alone. The others required gastrointestinal contrast series, or chest computed tomography to confirm the diagnosis. One referred patient had been misdiagnosed as having left pneumothorax. Cases of bowel malrotation and gastric volvulus associated with the hernia were found in one patient each. One patient required mechanical ventilation because of respiratory failure before surgery. Primary repair without patch was performed in all patients. The overall survival in this series was 100%.
CONCLUSION
Late-presenting diaphragmatic hernia should be suspected in cases of unexplained acute or chronic respiratory or gastrointestinal symptoms, and abnormal chest radiographic findings. The prognosis is favourable with correct diagnosis and prompt surgical repair.
Topics: Child; Child, Preschool; Diagnosis, Differential; Female; Gastrointestinal Diseases; Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Humans; Infant; Male; Prognosis; Respiration Disorders; Time Factors
PubMed: 20874742
DOI: 10.1111/j.1651-2227.2010.02025.x