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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 -
BMJ Case Reports Jun 2017A 70-year-old female patient presented with acute severe respiratory distress at a district general hospital. Medical history included type 2 diabetes, recurrent...
A 70-year-old female patient presented with acute severe respiratory distress at a district general hospital. Medical history included type 2 diabetes, recurrent pulmonary embolisms and pre-existing diaphragmatic hernia containing part of the liver. Despite initial treatment with steroid inhalers, her clinical picture rapidly deteriorated requiring emergency intubation and positive pressure ventilation. Imaging investigations revealed tension enterothorax and hepatothorax with tracheal deviation. The patient was transferred and underwent an emergency laparotomy at the Regional Oesophagogastric Unit. A large diaphragmatic hernia (central tendon defect) which contained the duodenum, porta hepatis, right lobe of liver, gallbladder and right colon was reduced and successfully repaired. Her postoperative course was uneventful with no signs of recurrence at 2 months follow-up.This case describes an extremely rare and life-threatening condition of tension enterothorax and hepatothorax, which should be considered in the differential diagnosis of acute respiratory distress with tracheal deviation.
Topics: Aged; Diagnosis, Differential; Emergency Treatment; Female; Hernia, Diaphragmatic; Humans; Intestine, Small; Laparotomy; Liver; Respiratory Distress Syndrome
PubMed: 28619969
DOI: 10.1136/bcr-2016-218571 -
Veterinary Medicine and Science Mar 2022To test the feasibility of a new device for gasless laparoscopy in providing working space for diaphragmatic hernia repair in an ex vivo canine model as a pre-clinical...
OBJECTIVES
To test the feasibility of a new device for gasless laparoscopy in providing working space for diaphragmatic hernia repair in an ex vivo canine model as a pre-clinical study.
STUDY DESIGN
Technical feasibility study.
ANIMAL
Eight beagles and two greyhound cadavers (not client-owned).
METHODS
The new device was used for abdominal traction in gasless laparoscopic reconstruction of diaphragmatic hernias produced in dog cadavers. It consists of three main parts (vertical and horizontal rods, a three-piece structure, and a 3D-printed unit that incorporates slots for haemostatic forceps). Composite hernias (two incisions of about 4 cm) were closed by an intra-corporeal suture [suture group (GS), n = 5] or by a central suture and a polypropylene mesh [mesh group (GM), n = 5]. Surgical steps were T1 (primary port access up to third port placement), T2 (defect development), and T3 (diaphragmatic reconstruction). Total surgical time (TT) was also recorded.
RESULTS
The defect was successfully developed and reconstructed in all cadavers. To close the defect, 7.0 ± 0.7 crossed mattress sutures were required in the GS, and 15.2 ± 1.9 hernia staples and one intra-corporal suture were used in the GM. T3 was longer (p = 0.0076) in GS (50.00 ± 16.46 min) than in GM (23.24 ± 5.25 min). TT was 87.22 ± 19.23 min in GS and 66.45 ± 6.38 min in GM (p = 0.0547).
CONCLUSIONS
Gasless laparoscopic diaphragmatic hernia repair using the developed device is feasible in the canine cadaver model. Both suture and mesh graft techniques for experimental diaphragmatic herniorrhaphy can be performed using this new device in this pre-clinical model.
CLINICAL SIGNIFICANCE
This new device for gasless laparoscopy allows diaphragmatic herniorrhaphy by intra-corporeal suture or mesh implantation in ex vivo canine model. The device demonstrates potential for future use in clinical cases.
Topics: Animals; Cadaver; Dog Diseases; Dogs; Hernia, Diaphragmatic; Herniorrhaphy; Laparoscopy; Surgical Mesh
PubMed: 34878226
DOI: 10.1002/vms3.675 -
Thorax Sep 1973, , 631-636. Nine patients with Margagni's hernia of the diaphragm are reported, seven of whom have been operated on. Four patients had gastrointestinal symptoms, two...
, , 631-636. Nine patients with Margagni's hernia of the diaphragm are reported, seven of whom have been operated on. Four patients had gastrointestinal symptoms, two respiratory symptoms, and one retrosternal pain; the other two were asymptomatic. In the first case the diagnosis was made at the time of thoracotomy, in the other eight it was suggested by radiological studies. The standard midline epigastric incision was used for repair in four cases and thoracotomy in two; the last patient was operated on through a preperitoneal subxiphoid route. This route has the advantage of not requiring a wide incision of peritoneum.
Topics: Adolescent; Aged; Barium Sulfate; Child; Female; Hernia, Diaphragmatic; Humans; Infant; Liver; Male; Middle Aged; Radiography
PubMed: 4784388
DOI: 10.1136/thx.28.5.631 -
Clinics (Sao Paulo, Brazil) Jun 2006To evaluate the perinatal results for neonates with congenital diaphragmatic hernia diagnosed prenatally.
PURPOSE
To evaluate the perinatal results for neonates with congenital diaphragmatic hernia diagnosed prenatally.
METHOD
We reviewed data from 38 cases of congenital diaphragmatic hernia diagnosed prenatally from January 1995 to December 2003 in the Fetal Medicine Unit of the Department of Obstetrics and Gynecology, São Paulo University Medical School. The main data analyzed were gestational age at diagnosis, fetal karyotyping, side of diaphragmatic defect, presence of associated structural malformations, hepatic herniation, and severe mediastinal shift. Perinatal outcomes were obtained by reviewing hospital documents or by directly calling the patients' immediate relatives.
RESULTS
Mean gestational age at diagnosis was 29 weeks (range, 16-37 weeks). Thirty (79%) cases had a left diaphragmatic defect and 8 (21%) had a right lesion. Associated structural malformations were observed in 21 (55%) cases, in which 12 fetuses had a normal karyotype and 9 had chromosomal abnormalities. Isolated congenital diaphragmatic hernia was confirmed in 17 (45%) cases. The overall perinatal mortality rate was 92%. Rates of fetal deaths, early neonatal deaths, late neonatal deaths, and survival were 42%, 50%, 0%, and 8%, respectively, in cases with associated structural malformations but normal karyotyping; 56%, 44%, 0%, and 0% for cases with chromosomal abnormalities; and, 0%, 76%, 12%, and 12% in cases with isolated congenital diaphragmatic hernia. The neonatal mortality rate was 89% in cases with isolated congenital diaphragmatic hernia.
CONCLUSION
Perinatal mortality was very high in prenatally diagnosed cases of congenital diaphragmatic hernia. Earlier perinatal deaths are associated with the presence of other structural defects or chromosomal abnormalities. In cases of isolated congenital diaphragmatic hernia, mortality is related to the presence of herniated liver, right-sided lesion, and major mediastinal shift.
Topics: Abnormalities, Multiple; Brazil; Chromosome Aberrations; Female; Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Humans; Infant, Newborn; Karyotyping; Pregnancy; Pregnancy Outcome; Prognosis; Retrospective Studies; Ultrasonography, Prenatal
PubMed: 16832551
DOI: 10.1590/s1807-59322006000300003 -
BMJ Case Reports Sep 2012Asymptomatic diaphragmatic hernias in reproductive-aged women are rare but pose significant morbidity for pregnancy. This is a case of a woman at 29 weeks' gestation...
Asymptomatic diaphragmatic hernias in reproductive-aged women are rare but pose significant morbidity for pregnancy. This is a case of a woman at 29 weeks' gestation with abdominal pain and shortness of breath. Five years prior she had been incidentally diagnosed with a small congenital diaphragmatic hernia of Bochdalek. Following preconception care, she opted against repair of the hernia prior to pregnancy due to lack of symptoms and no clear recommendation for repair from the surgeon. Imaging studies on emergency room presentation demonstrated a large herniation of viscera into her chest occupying her entire left chest with slight cardiac displacement. Through a multidisciplinary approach, she was stabilised and eventually delivered at 31 weeks due to worsening pulmonary function. The hernia was repaired postpartum. We recommend repair of any diaphragmatic hernia prior to conception to prevent significant maternal and fetal morbidity or mortality. A multidisciplinary approach allows for planning.
Topics: Adult; Cesarean Section; Female; Hernia, Diaphragmatic; Humans; Magnetic Resonance Imaging; Pregnancy; Pregnancy Complications
PubMed: 22967686
DOI: 10.1136/bcr-2012-006859 -
Medicina 2021
Topics: Hernia, Diaphragmatic; Hernia, Hiatal; Humans
PubMed: 34875616
DOI: No ID Found -
Proceedings of the Royal Society of... Jan 1958
Topics: Diaphragm; Hernia, Diaphragmatic; Hernia, Hiatal
PubMed: 13518146
DOI: No ID Found -
Indian Pediatrics Nov 2013We conducted this study to assess the value of presence of hernia sac in prediction of postoperative outcome in congenital diaphragmatic hernia (CDH). Data were obtained...
We conducted this study to assess the value of presence of hernia sac in prediction of postoperative outcome in congenital diaphragmatic hernia (CDH). Data were obtained form medical records of 70 children operated for CDH between 2002-12. Postoperative neonatal death occurred in 1/10 (10%) of infants with a hernia sac and 26/60 (43.3%) in cases without a hernia sac, respectively (P =0.04). Perinatal morbidity in surviving infants was lower in the group with a hernia sac although not significantly. We conclude that the presence of a hernia sac is associated with better postoperative outcome and overall prognosis of CDH.
Topics: Female; Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Humans; India; Infant, Newborn; Male; Postoperative Complications; Retrospective Studies; Treatment Outcome
PubMed: 23798629
DOI: 10.1007/s13312-013-0276-9 -
Chirurgia (Bucharest, Romania : 1990) 2013Spontaneous diaphragm rupture is extremely rare. Usually a diaphragm rupture is trauma induced. We describe a case of an 18-year old patient admitted 2 hours after... (Review)
Review
Spontaneous diaphragm rupture is extremely rare. Usually a diaphragm rupture is trauma induced. We describe a case of an 18-year old patient admitted 2 hours after onset, presenting severe epigastric and left sided chest pain without any trauma history. Upright chest x-ray revealed displaced stomach and colon into the left pleural cavity with a collapsed left lung. Surgery for a left-sided diaphragm rupture with stomach, spleen and colon splenic flexure herniation was undertaken. We present a brief review regarding the aetiology, diagnostic and treatment policy of spontaneous diaphragmatic rupture.
Topics: Adolescent; Colonic Diseases; Diagnosis, Differential; Follow-Up Studies; Hernia, Diaphragmatic; Humans; Male; Pneumothorax; Radiography; Rupture, Spontaneous; Splenic Diseases; Stomach Volvulus; Treatment Outcome
PubMed: 23464778
DOI: No ID Found