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Annals of the Royal College of Surgeons... Nov 2016Gastric perforation into the thoracic cavity through a diaphragmatic hernia is rare but, when it occurs, patients present in severe distress, with mortality approaching...
Gastric perforation into the thoracic cavity through a diaphragmatic hernia is rare but, when it occurs, patients present in severe distress, with mortality approaching 50%. We present a unique case in which a fibrotic reaction between the stomach and the parietal pleura led to a subacute presentation upon perforation. The extra time that this afforded led to more effective multidisciplinary team management and ultimately an excellent outcome for the patient.
Topics: Aged; Chest Pain; Hernia, Diaphragmatic; Humans; Male; Spontaneous Perforation; Stomach; Stomach Diseases; Tomography, X-Ray Computed
PubMed: 27502341
DOI: 10.1308/rcsann.2016.0228 -
The Pan African Medical Journal 2021Congenital diaphragmatic hernia (CDH) is known as a structural defect caused by inadequate fusion of the pleuroperitoneal membrane forming the diaphragm, allowing...
Congenital diaphragmatic hernia (CDH) is known as a structural defect caused by inadequate fusion of the pleuroperitoneal membrane forming the diaphragm, allowing peritoneal viscera to protrude into the pleural cavity. It affects nearly one out of 2500 live births. We here report the case of a six-month-old boy with left diaphragmatic hernia presenting with poor feeding, breathing difficulty, cough, and recurrent pneumonia in the last 2 months. Chest X-ray and computed tomography scan revealed left sided CDH. The defect was corrected through open surgical repair without complications. At 5-month follow-up a radiograph was performed which revealed full recovery. The primary goal of this report was to alert physicians to suspect this diagnosis in patients with unexpected presentation of diaphragmatic hernia.
Topics: Abdomen; Diaphragm; Hernia, Hiatal; Hernias, Diaphragmatic, Congenital; Humans; Infant; Male; Radiography
PubMed: 35233262
DOI: 10.11604/pamj.2021.40.242.32113 -
Singapore Medical Journal Sep 2008Outcome of neonates with congenital diaphragmatic hernia (CDH) varies widely and the data from developing countries is scanty. We aimed to study the management and...
INTRODUCTION
Outcome of neonates with congenital diaphragmatic hernia (CDH) varies widely and the data from developing countries is scanty. We aimed to study the management and outcome of CDH. We also aimed to ascertain prenatal and postnatal factors affecting the outcome.
METHODS
A retrospective review of neonates with CDH admitted to a teaching hospital was conducted. Demographical data, prenatal and postnatal factors, birth details, management and outcomes were studied. Survival was the primary outcome.
RESULTS
16 live-born neonates with diaphragmatic hernia were admitted during the study period. All neonates had hernia on the left side. Mean (standard deviation) gestational age and birth weight were 38.6 (1.5) weeks and 2,616.6 (457) g, respectively. Polyhydramnios was associated in one patient, and additional anomalies in five patients (31.3 percent). Overall survival was 56.3 percent. The CDH was detected prenatally in four and postnatally in 12 patients. 12 neonates underwent surgery and nine survived. Prenatally-detected cases had significantly reduced survival to surgery, overall survival and lower Apgar scores at one minute (p-value is less than 0.04). Median age at surgery was 48 hours. Average duration of mechanical ventilation among survivors was 91.5 hours. Neonatal intensive care unit stay ranged from five to 27 (median nine) days. Six of seven deaths occurred within 72 hours of life. Non-survivors had significantly low Apgar scores and were symptomatic within 12 hours of life (p-value is less than 0.03).
CONCLUSION
Greater than 50 percent survival of neonates with CDH was observed in a centre with conventional ventilation. Poor outcome is likely in neonates who present within 12 hours of life.
Topics: Abnormalities, Multiple; Birth Weight; Developing Countries; Female; Gestational Age; Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Humans; India; Infant; Infant, Newborn; Male; Pregnancy; Retrospective Studies; Time Factors; Treatment Outcome
PubMed: 18830547
DOI: No ID Found -
Journal of Ayub Medical College,... 2022Congenital Bochdalek diaphragmatic hernia (CDH) is the most common embryologic defect of the diaphragm which occurs 1 in 2500-5000 live births. Most commonly CDH...
Congenital Bochdalek diaphragmatic hernia (CDH) is the most common embryologic defect of the diaphragm which occurs 1 in 2500-5000 live births. Most commonly CDH presents soon after birth but it can present late in 10-30% of cases, leading to a diagnostic dilemma. Late presenting patients can remain asymptomatic for a variable period before presenting with complications in the form of obstruction or strangulation of gut. Bochdalek diaphragmatic hernia presenting with strangulation of gut is very rare. We report a case of such a rare variety of strangulated Bochdalek left diaphragmatic hernia in an 11-month-old boy which was managed successfully.
Topics: Male; Humans; Infant; Hernias, Diaphragmatic, Congenital
PubMed: 36550668
DOI: 10.55519/JAMC-04-S4-9804 -
British Medical Journal Jul 1976
Topics: Endoscopy; Hernia, Diaphragmatic; Hernia, Hiatal; Humans
PubMed: 974517
DOI: 10.1136/bmj.2.6029.237-b -
Ultrasound in Obstetrics & Gynecology :... Jan 2012Fetuses with congenital diaphragmatic hernia (CDH) and for whom additional ultrasound findings are abnormal typically are considered to have a dismal prognosis. Our aim...
OBJECTIVE
Fetuses with congenital diaphragmatic hernia (CDH) and for whom additional ultrasound findings are abnormal typically are considered to have a dismal prognosis. Our aim was to assess the outcome of fetuses with CDH and associated intrafetal fluid effusions.
METHODS
This was a retrospective bicentric cohort study on the perinatal management of fetuses with CDH and intrafetal fluid effusions.
RESULTS
The incidence of effusions was 5.2% (n = 14) in 269 consecutive cases of left-sided CDH and 29.2% (n = 14) in 48 cases of right-sided CDH. Hydrothorax (n = 19 (68%)) and ascites (n = 16 (57%)) were the most common effusions. A combination of both was present in 11 (39%) fetuses. Of 20 ongoing pregnancies with CDH and fluid effusions, without other anomalies, five with moderate or mild pulmonary hypoplasia were managed without fetoscopic endoluminal tracheal occlusion (FETO). The 15 other cases underwent FETO because of severe pulmonary hypoplasia. Neonatal survival rate was similar in both groups (n = 2/5 and n = 6/15, respectively (P = 1.0)). Survival among those who underwent FETO was similar to previously published results concerning isolated cases undergoing FETO.
CONCLUSIONS
Our observations do not support the view that intrafetal effusions are an adverse prognostic factor in fetuses with CDH. In CDH fetuses with effusions and severe pulmonary hypoplasia treated with FETO, neonatal survival is similar to that in isolated cases undergoing the intervention. Whether pleural effusions should be addressed by thoracic drainage procedures remains unproven.
Topics: Balloon Occlusion; Cohort Studies; Female; Fetoscopy; Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Humans; Incidence; Infant, Newborn; Male; Pleural Effusion; Pregnancy; Prognosis; Retrospective Studies; Survival Rate; Trachea; Ultrasonography, Prenatal
PubMed: 21910146
DOI: 10.1002/uog.10097 -
Journal de Gynecologie, Obstetrique Et... May 2013Congenital diaphragmatic hernia (CDH) is a rare disease (1/3000 live births). Carriers display a diaphragmatic defect responsible for an impaired pulmonary development...
AIM
Congenital diaphragmatic hernia (CDH) is a rare disease (1/3000 live births). Carriers display a diaphragmatic defect responsible for an impaired pulmonary development and physiology. The aim of this study was to evaluate the information given to couples whose fetus display a CDH and the current knowledge of French sonographers about this disease.
MATERIALS AND METHODS
A questionnaire was sent by email to 2000 sonographers, members of the French college of fetal ultrasonography, between May 1st and December 31st of 2010.
RESULTS
20,7 % (414) of the sonographers answered. Twenty-four percent are second line sonographers. Thirty-eight percent did not diagnose any diaphragmatic hernia in the last five years (2005-2010) and 42 % diagnosed 1 or 2 during the same period. Information concerning the prognostic remains elusive and most sonographers rapidly referred patients to prenatal diagnostic centers. Fifty-nine percent of sonographer are not aware of the existence in France of a Centre for Rare Disease for CDH.
CONCLUSION
Accurate assessment of prognosis is essential to provide adequate information to couples and to help them make a decision on whether or not to perform an in utero treatment. The heterogenous results of the survey clearly show the disparities between sonographers on the type of information delivered. A better diffusion of prognostic evaluation in CDH, among sonographers is needed.
Topics: Adult; Aged; Attitude of Health Personnel; Clinical Competence; Data Collection; Disclosure; Female; Health Knowledge, Attitudes, Practice; Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Humans; Male; Middle Aged; Physicians; Pregnancy; Prognosis; Ultrasonography, Prenatal
PubMed: 23490408
DOI: 10.1016/j.jgyn.2012.12.001 -
Journal of Pediatric Surgery Oct 2013To determine developmental outcomes and associated factors in patients with congenital diaphragmatic hernia (CDH) at 2 years of age. (Clinical Trial)
Clinical Trial
PURPOSE
To determine developmental outcomes and associated factors in patients with congenital diaphragmatic hernia (CDH) at 2 years of age.
METHODS
This is a multicenter prospective study of a CDH birth cohort. Clinical and socioeconomic data were collected. Bayley Scales of Infant Development (BSID-III) and Vineland Adaptive Behavior Scales (VABS-II) were performed at 2 years of age.
RESULTS
BSID-III and VABS-II assessments were completed on 48 and 49 children, respectively. The BSID-III mean cognitive, language, and motor scores were significantly below the norm mean with average scores of 93 ± 15, 95 ± 16, and 95 ± 11. Ten percent (5/47) scored more than 2 standard deviations below the norm on one or more domains. VABS-II scores were similar to BSID-III scores with mean communication, daily living skills, social, motor, adaptive behavior scores of 97 ± 14, 94 ± 16, 93 ± 13, 97 ± 10, and 94 ± 14. For the BSID-III, supplemental oxygen at 28 days, a prenatal diagnosis, need for extracorporeal membrane oxygenation (ECMO) and exclusive tube feeds at time of discharge were associated with lower scores. At 2 years of age, history of hospital readmission and need for tube feeds were associated with lower scores. Lower socioeconomic status correlated with lower developmental scores when adjusted for significant health factors.
CONCLUSION
CDH patients on average have lower developmental scores at 2 years of age compared to the norm. A need for ECMO, oxygen at 28 days of life, ongoing health issues and lower socioeconomic status are factors associated with developmental delays.
Topics: Child Behavior Disorders; Child, Preschool; Developmental Disabilities; Extracorporeal Membrane Oxygenation; Female; Follow-Up Studies; Health Status; Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Humans; Infant, Newborn; Linear Models; Male; Oxygen Inhalation Therapy; Prospective Studies; Psychological Tests; Risk Factors; Socioeconomic Factors
PubMed: 24094947
DOI: 10.1016/j.jpedsurg.2013.02.041 -
Diagnostic and Interventional Radiology... Mar 2010To determine the frequency of asymptomatic incidental Bochdalek hernias in adults, using multidetector computed tomography (MDCT), and to ascertain any possible...
PURPOSE
To determine the frequency of asymptomatic incidental Bochdalek hernias in adults, using multidetector computed tomography (MDCT), and to ascertain any possible relationship between Bochdalek hernia and age, gender, or body mass index (BMI).
MATERIALS AND METHODS
Seven hundred and forty-eight abdominal, and 602 chest MDCT scans, which had been performed for a variety of reasons on 1350 adults, were investigated retrospectively. Location and size of Bochdalek hernias seen on these scans were correlated with age, gender, and BMI. On the basis of BMI, patients with Bochdalek hernia were classified as group A (BMI < 25) and group B (BMI > or =25).
RESULTS
A total of 171 Bochdalek hernias were identified in 142 of 1350 patients, ranging in age from 25 to 90 years (median age, 57.2), representing a prevalence of 10.5%. Sixty leftsided unilateral Bochdalek hernias (42.2%), 53 (37.4%) rightsided unilateral Bochdalek hernias, and 29 (20.4%) bilateral Bochdalek hernias were detected. Forty-five (31.6%) were categorized as small, 82 (57.8%) were medium-sized, and 15 (10.5%) were large. BMI was < 25 in 62 patients (43.7%), and > or =25 in 80 patients (56.3%). Fourteen patients (9.9%) were young adults, while 86 (60.6%) were middle aged, and 42 (29.6%) were elderly. No statistically significant relationship was found between dimensions or hernia locations and age, gender, or BMI of patients with Bochdalek hernia.
CONCLUSION
In view of the high prevalence of Bochdalek hernia in our study (10.5%), the multiplanar and reconstruction features of MDCT seem to facilitate the diagnosis of asymptomatic incidental Bochdalek hernia. No relationship was found between asymptomatic incidental Bochdalek hernia and age, gender, or BMI in adults.
Topics: Adult; Aged; Aged, 80 and over; Body Mass Index; Female; Functional Laterality; Hernia, Diaphragmatic; Humans; Middle Aged; Retrospective Studies; Tomography, X-Ray Computed; Turkey
PubMed: 20039230
DOI: 10.4261/1305-3825.DIR.2750-09.1 -
Interactive Cardiovascular and Thoracic... Oct 2012Morgagni hernia (MH) is an uncommon type of diaphragmatic hernia. This study aimed to summarize clinically relevant data with respect to MHs in adults.
OBJECTIVES
Morgagni hernia (MH) is an uncommon type of diaphragmatic hernia. This study aimed to summarize clinically relevant data with respect to MHs in adults.
METHODS
We performed a retrospective chart review of patients who underwent surgical repair of foramen due to MH at our hospitals between 1996 and 2010. Data were collected on patient demographics, presenting symptoms, modes of diagnosis, surgical procedures, surgery outcomes, recurrence of hernia and follow-up of the patients.
RESULTS
We included 36 patients with the mean age of 50.2 years. Of these 66.7% (n = 24) were female. Thirty-one patients had MH on the right side and 1 patient had bilateral MH. Most of the patients experienced abdominal symptoms. 72.2% of patients underwent laparotomy (n = 26, 72.2%), (n = 6, 16.7%) thoracotomy (n = 6, 16.7%), and a thoraco-abdominal approach (n = 4, 11.1%). Resection of the hernia sac and insertion of a mesh were not done in any patients. No recurrence occurred.
CONCLUSIONS
We conclude that preoperative diagnosis and early diagnosis of MH by using laparotomy and thoracotomy is useful for safe and effective repair. Also we suggest that resection of the hernia sac and insertion of a mesh are not necessary.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Early Diagnosis; Female; Hernia, Diaphragmatic; Herniorrhaphy; Humans; Male; Middle Aged; Predictive Value of Tests; Recurrence; Retrospective Studies; Thoracotomy; Time Factors; Treatment Outcome; Young Adult
PubMed: 22778140
DOI: 10.1093/icvts/ivs203