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Experimental and Clinical... Oct 2015Diaphragmatic hernia is an unusual complication after pediatric liver transplant. Nearly half of bowel obstruction cases, which require surgical intervention in liver...
Diaphragmatic hernia is an unusual complication after pediatric liver transplant. Nearly half of bowel obstruction cases, which require surgical intervention in liver transplant patients, are caused by diaphragmatic hernia. The smaller patients are at risk for higher rates of diaphragmatic complication after pediatric liver transplant, but diaphragmatic hernia has not been reported as a unique occurrence. Here, we report 3 cases of diaphragmatic hernia after liver transplant and discuss the possible contributing factors. Diaphragmatic hernia should nevertheless be added to the list of potential complications after liver transplant in the pediatric population. Pediatric transplant physicians and surgeons should be aware of this complication so that it is recognized promptly in both acute and nonacute settings and appropriate action is taken.
Topics: Age Factors; Child, Preschool; Female; Hernia, Diaphragmatic; Herniorrhaphy; Humans; Infant; Liver Transplantation; Male; Reoperation; Risk Factors; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 26450470
DOI: No ID Found -
California Medicine Nov 1954Treatment of congenital diaphragmatic hernia in infants is a matter of semi-emergency and should be done as soon as adequate preparations can be made because sometimes...
Treatment of congenital diaphragmatic hernia in infants is a matter of semi-emergency and should be done as soon as adequate preparations can be made because sometimes fatal complications develop swiftly. In preoperative preparation there is great advantage in thorough decompression of the abdominal viscera, stomach, bowel and bladder. As to operation, the author believes the abdominal approach has most to recommend it. In the postoperative period, continued gastric suction for a brief time, parenteral administration of fluids and use of a Mistogen tent with a high moist oxygen content will facilitate rapid recovery.
Topics: Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Humans; Infant; Postoperative Period; Stomach; Suction
PubMed: 13209363
DOI: No ID Found -
Journal of the American Veterinary... Mar 2013To determine clinical findings and outcomes for cats and dogs with peritoneopericardial diaphragmatic hernia (PPDH) treated surgically or nonsurgically.
OBJECTIVE
To determine clinical findings and outcomes for cats and dogs with peritoneopericardial diaphragmatic hernia (PPDH) treated surgically or nonsurgically.
DESIGN
Retrospective case series.
ANIMALS
28 dogs and 30 cats.
PROCEDURES
Medical records for cats and dogs evaluated at 1 of 2 veterinary teaching hospitals were reviewed, and data regarding clinical signs, diagnostic and surgical findings, and outcome were evaluated.
RESULTS
Prevalence of PPDH in the 2 hospitals during the study period was 0.025% (0.062% and 0.015% for cats and dogs, respectively); PPDH was an incidental finding for 13 (46.4%) dogs and 15 (50.0%) cats. Other congenital abnormalities were identified in 16 (571%) dogs and 7 (23.3%) cats (most commonly umbilical hernias, abdominal wall hernias cranial to the umbilicus, or sternal anomalies). Thirty-four (58.6%) animals underwent surgical repair of PPDH; 27 (79.4%) of these animals had a primary diagnosis of PPDH. Detection of clinical signs of PPDH (primary diagnosis) and intestines in the pericardial sac were significantly associated with surgical treatment. Short-term mortality rate for surgically treated animals was 8.8% (3/34). Clinical signs associated with PPDH resolved in 29 (85.3%) of surgically treated animals. No significant differences were detected between dogs and cats or between surgically and nonsurgically treated animals regarding long-term survival rate.
CONCLUSIONS AND CLINICAL RELEVANCE
Results of this study indicated animals with clinical signs of PPDH were more likely to undergo surgery than were animals without such signs. Herniorrhaphy was typically effective for resolution of clinical signs. Long-term survival rates were similar regardless of treatment method. Surgical or nonsurgical treatment of PPDH may be appropriate for animals with or without clinical signs, respectively.
Topics: Animals; Cat Diseases; Cats; Dog Diseases; Dogs; Female; Hernia, Diaphragmatic; Male; Retrospective Studies
PubMed: 23402411
DOI: 10.2460/javma.242.5.643 -
The FEBS Journal Sep 2013The mammalian diaphragm muscle is essential for respiration, and thus is one of the most critical skeletal muscles in the human body. Defects in diaphragm development... (Review)
Review
The mammalian diaphragm muscle is essential for respiration, and thus is one of the most critical skeletal muscles in the human body. Defects in diaphragm development leading to congenital diaphragmatic hernias (CDH) are common birth defects and result in severe morbidity or mortality. Given its functional importance and the frequency of congenital defects, an understanding of diaphragm development, both normally and during herniation, is important. We review current knowledge of the embryological origins of the diaphragm, diaphragm development and morphogenesis, as well as the genetic and developmental aetiology of diaphragm birth defects.
Topics: Animals; Diaphragm; Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Humans; Muscle, Skeletal; Respiration
PubMed: 23586979
DOI: 10.1111/febs.12274 -
Ultrasound in Obstetrics & Gynecology :... Nov 2007Fetal surgery to improve lung growth comprises tracheal occlusion in selected 'high-risk' fetuses with congenital diaphragmatic hernia (CDH). Sonographically measured... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Fetal surgery to improve lung growth comprises tracheal occlusion in selected 'high-risk' fetuses with congenital diaphragmatic hernia (CDH). Sonographically measured fetal lung-to-head ratio (LHR) is utilized to recruit candidates for fetal surgery. This study provides a meta-analysis of the evidence regarding the prognostic use of lung-to-head ratio measurements in fetal CDH.
METHODS
MEDLINE, SCOPUS and ISI PROCEEDINGS databases were searched for MeSH terms: lung, head, hernia and ratio. References in retrieved studies were also searched. Studies were categorized as follows: Phase I studies measured normal fetal LHR; Phase II studies compared fetal LHR in CDH survivors and non-survivors (if LHR informed therapy decisions or LHR was not measured during the window for intervention (< 32 weeks' gestation), studies were excluded); Phase III studies used LHR to guide selection for fetal surgery (non-randomized trials were excluded); Phase IV studies measured CDH survival before and after LHR application in clinical practice.
RESULTS
The one Phase I study showed that LHR varied substantially with gestation and technique. No complete studies met the selection criteria for Phase II: meta-analysis of subgroups revealed similar LHR in CDH survivors and non-survivors. A single Phase III study revealed no benefit for LHR-directed fetal surgery. No Phase IV studies were identified.
CONCLUSION
The prognostic use of LHR in fetal CDH entered clinical practice prior to publication of robust normal data and is not supported by current evidence. Application of a structured approach to any 'new' prognostic test could improve its validity and clinical application.
Topics: Cephalometry; Female; Fetal Diseases; Gestational Age; Hernia, Diaphragmatic; Humans; Infant, Newborn; Lung Volume Measurements; Male; Predictive Value of Tests; Pregnancy; Pregnancy Outcome; Pregnancy Trimester, Second; Regression Analysis; Ultrasonography
PubMed: 17963204
DOI: 10.1002/uog.5164 -
Postgraduate Medical Journal Nov 1986
Topics: Diaphragm; Hernia, Diaphragmatic; Humans; Male; Middle Aged; Time Factors
PubMed: 3628157
DOI: 10.1136/pgmj.62.733.1067 -
Acta Biomaterialia Apr 2019Congenital diaphragmatic hernia (CDH) is a neonatal defect in which the diaphragm muscle does not develop properly, thereby raising abdominal organs into the thoracic...
Congenital diaphragmatic hernia (CDH) is a neonatal defect in which the diaphragm muscle does not develop properly, thereby raising abdominal organs into the thoracic cavity and impeding lung development and function. Large diaphragmatic defects require correction with prosthetic patches to close the malformation. This treatment leads to a consequent generation of unwelcomed mechanical stress in the repaired diaphragm and hernia recurrences, thereby resulting in high morbidity and significant mortality rates. We proposed a specific diaphragm-derived extracellular matrix (ECM) as a scaffold for the treatment of CDH. To address this strategy, we developed a new surgical CDH mouse model to test the ability of our tissue-specific patch to regenerate damaged diaphragms. Implantation of decellularized diaphragmatic ECM-derived patches demonstrated absence of rejection or hernia recurrence, in contrast to the performance of a commercially available synthetic material. Diaphragm-derived ECM was able to promote the generation of new blood vessels, boost long-term muscle regeneration, and recover host diaphragmatic function. In addition, using a GFP + Schwann cell mouse model, we identified re-innervation of implanted patches. These results demonstrated for the first time that implantation of a tissue-specific biologic scaffold is able to promote a regenerating diaphragm muscle and overcome issues commonly related to the standard use of prosthetic materials. STATEMENT OF SIGNIFICANCE: Large diaphragmatic hernia in paediatric patients require application of artificial patches to close the congenital defect. The use of a muscle-specific decellularized scaffold in substitution of currently used synthetic materials allows new blood vessel growth and nerve regeneration inside the patch, supporting new muscle tissue formation. Furthermore, the presence of a tissue-specific scaffold guaranteed long-term muscle regeneration, improving diaphragm performance to almost complete functional recovery. We believe that diaphragm-derived scaffold will be key player in future pre-clinical studies on large animal models.
Topics: Allografts; Animals; Extracellular Matrix; Female; Hernia, Diaphragmatic; Male; Mice; Mice, Inbred BALB C; Muscle, Skeletal; Regeneration; Tissue Scaffolds
PubMed: 30851456
DOI: 10.1016/j.actbio.2019.03.007 -
British Medical Journal Oct 1967
Topics: Anemia; Angina Pectoris; Deglutition Disorders; Diagnosis, Differential; Gastroesophageal Reflux; Gastrointestinal Hemorrhage; Heartburn; Hernia, Diaphragmatic; Humans; Pain; Thoracic Diseases
PubMed: 5299417
DOI: 10.1136/bmj.4.5573.218 -
Postgraduate Medical Journal Aug 1968
Topics: Hernia, Diaphragmatic; Humans; Radiography
PubMed: 5679276
DOI: 10.1136/pgmj.44.514.579 -
British Medical Journal May 1949
Topics: Anemia; Hernia, Diaphragmatic; Hernia, Hiatal; Humans; Syndrome
PubMed: 18126371
DOI: 10.1136/bmj.1.4609.805