1
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Ahmad M, Al-Arifi A, Najm HK. Giant Hernia of Morgagni with Acute Coronary Syndrome: A Rare Case Report and Review of Literature. Heart Lung Circ 2015; 24:e144-7. [DOI: 10.1016/j.hlc.2015.04.166] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 04/09/2015] [Accepted: 04/14/2015] [Indexed: 11/30/2022]
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2
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Chaparro Mendoza K, Cruz Suarez G, Suguimoto A. Crisis anestésica en cirugía laparoscópica: neumotórax espontáneo bilateral. Diagnóstico y manejo, reporte de caso. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2015. [DOI: 10.1016/j.rca.2015.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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3
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Chaparro Mendoza K, Cruz Suarez G, Suguimoto A. Anesthesia crisis in laparoscopic surgery: Bilateral spontaneous pneumothorax. Diagnosis and management, case report. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2015. [DOI: 10.1016/j.rcae.2015.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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4
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Anesthesia crisis in laparoscopic surgery: Bilateral spontaneous pneumothorax. Diagnosis and management, case report☆. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2015. [DOI: 10.1097/01819236-201543020-00012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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5
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Oulahyane R, Bentalha A, Abbassi A, Kisra M, El Koraichi A. [Anterolateral diaphragmatic hernia: case report]. Arch Pediatr 2014; 21:507-9. [PMID: 24721415 DOI: 10.1016/j.arcped.2014.02.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 10/10/2013] [Accepted: 02/20/2014] [Indexed: 11/15/2022]
Abstract
Congenital anterolateral diaphragmatic hernia is rare, with few cases reported in the literature. This anomaly is usually associated with left pulmonary hypoplasia. Treatment is surgical and prognosis depends on the presence and severity of associated malformations. We report a case of an intraoperative discovery of this unusual type of diaphragmatic hernia in an infant.
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Affiliation(s)
- R Oulahyane
- Faculté de médecine, université Mohammed V-Souissi, BP 5071, Souissi, Rabat, Maroc; Service de chirurgie viscérale infantile, hôpital d'Enfant, Rabat, Maroc
| | - A Bentalha
- Faculté de médecine, université Mohammed V-Souissi, BP 5071, Souissi, Rabat, Maroc; Service de chirurgie viscérale infantile, hôpital d'Enfant, Rabat, Maroc; Service d'anesthésie réanimation pédiatrique polyvalente, hôpital d'enfants, Rabat, Maroc
| | - A Abbassi
- Service de chirurgie viscérale infantile, hôpital d'Enfant, Rabat, Maroc
| | - M Kisra
- Faculté de médecine, université Mohammed V-Souissi, BP 5071, Souissi, Rabat, Maroc; Service de chirurgie viscérale infantile, hôpital d'Enfant, Rabat, Maroc
| | - A El Koraichi
- Faculté de médecine, université Mohammed V-Souissi, BP 5071, Souissi, Rabat, Maroc; Service de chirurgie viscérale infantile, hôpital d'Enfant, Rabat, Maroc; Service d'anesthésie réanimation pédiatrique polyvalente, hôpital d'enfants, Rabat, Maroc.
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6
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Merrell AJ, Kardon G. Development of the diaphragm -- a skeletal muscle essential for mammalian respiration. FEBS J 2013; 280:4026-35. [PMID: 23586979 DOI: 10.1111/febs.12274] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 03/27/2013] [Accepted: 03/28/2013] [Indexed: 12/26/2022]
Abstract
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.
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Affiliation(s)
- Allyson J Merrell
- Department of Human Genetics, University of Utah, Salt Lake City, UT 84112, USA
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7
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Nagase H, Ishikawa H, Kurosawa K, Furuya N, Itani Y, Yamanaka M. Familial severe congenital diaphragmatic hernia: left herniation in one sibling and bilateral herniation in another. Congenit Anom (Kyoto) 2013; 53:54-7. [PMID: 23480359 DOI: 10.1111/j.1741-4520.2012.00363.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Familial congenital diaphragmatic hernia (CDH) is extremely rare; it comprises about 2% of all CDH cases. The empirical risk is about 2%, increasing to 10% in a family with two affected children. This report describes severe CDH in two siblings who had been diagnosed prenatally. The female newborn diagnosed with left CDH prenatally was born at 38 weeks of gestation. Despite surgical repair and intensive treatment, she died 10 days after birth. Her younger brother was born at 39 weeks of gestation after being diagnosed with bilateral CDH prenatally, and died 75 min after birth. Both infants had neither other congenital anomaly nor chromosomal abnormalities. Their parents are healthy without consanguinity. Their first daughter and the fourth child have no congenital anomalies.
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Affiliation(s)
- Hiromi Nagase
- Division of Obstetrics and Gynecology, Yokohama Minami Kyosai Hospital, Kanagawa, Japan.
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8
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Scahill MD, Maak P, Kunder C, Halamek LP. Anterolateral congenital diaphragmatic hernia with omphalocele: A case report and literature review. Am J Med Genet A 2013; 161A:585-8. [DOI: 10.1002/ajmg.a.35703] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Accepted: 09/01/2012] [Indexed: 11/08/2022]
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9
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Ackerman KG, Vargas SO, Wilson JA, Jennings RW, Kozakewich HP, Pober BR. Congenital diaphragmatic defects: proposal for a new classification based on observations in 234 patients. Pediatr Dev Pathol 2012; 15:265-74. [PMID: 22257294 PMCID: PMC3761363 DOI: 10.2350/11-05-1041-oa.1] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Congenital diaphragmatic defects (CDDs) are a common group of birth defects, yet we presently know little about their pathogenesis. No systematic study documenting the detailed morphology of CDD has been performed, and current classification schemata of diaphragm phenotypes incompletely capture the location and extent of diaphragmatic involvement. To define the range of CDD anatomy, diaphragmatic pathology was reviewed from an examination of 181 autopsy records of children with CDDs at Children's Hospital Boston between 1927 and 2006. Defects were classified according to several parameters, including type (communicating versus noncommunicating) and location (anterior, posterior, etc.). The information permitted development of a phenotyping worksheet for prospective use on patients undergoing diaphragmatic repair at Children's Hospital Boston or MassGeneral Hospital for Children. Fifty-three patients who died between 1990 and 2006 had a total of 63 defects. Thirty-nine had a "classic" CDD phenotype (64% posterolateral, 18% hemidiaphragmatic aplasia, and 18% anterior). The remaining 19 defects, not fitting classical descriptions, were located in the posteromedial, anterolateral, or lateral regions of the diaphragm. Prospective data collected during surgical repair revealed posterolateral defects in 34 of 41 cases that demonstrated wide phenotypic variability in size, location, shape, type, and extent of organ displacement. Congenital diaphragmatic defects display significant phenotypic variation. Because rigorous anatomic evaluation and documentation are important steps towards elucidating the developmental biology of these disorders, we suggest establishment of a new and more precise classification using the model presented herein.
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Affiliation(s)
- Kate G. Ackerman
- Center for Pediatric Biomedical Research, University of Rochester, Rochester, NY, USA
,Department of Pediatrics (Division of Critical Care) and Department of Biomedical Genetics, University of Rochester, Rochester, NY, USA
,Corresponding author,
| | - Sara O. Vargas
- Harvard Medical School, Boston, MA, USA
,Department of Pathology, Children’s Hospital, Boston, MA, USA
| | - Jay A. Wilson
- Harvard Medical School, Boston, MA, USA
,Department of Surgery, Children’s Hospital, Boston, MA, USA
| | - Russell W. Jennings
- Harvard Medical School, Boston, MA, USA
,Department of Surgery, Children’s Hospital, Boston, MA, USA
| | - Harry P.W. Kozakewich
- Harvard Medical School, Boston, MA, USA
,Department of Pathology, Children’s Hospital, Boston, MA, USA
| | - Barbara R. Pober
- Harvard Medical School, Boston, MA, USA
,Department of Surgery, Children’s Hospital, Boston, MA, USA
,Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
,Pediatric Surgical Research Laboratories, Massachusetts General Hospital, Boston, MA, USA
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10
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Abstract
Chicken ovalbumin upstream promoter transcription factors (COUP-TFs) belong to the steroid/thyroid hormone receptor superfamily. Cloning of their cDNAs demonstrated the existence of two distinct but related genes: COUP-TFI (EAR-3, NR2F1) and COUP-TFII (ARP-1, NR2F2). They are referred to as orphan receptors because ligands for COUP-TFs have yet to be identified. Since 1998, extensive studies have demonstrated their physiological importance in cell-fate specification, organogenesis, angiogenesis, and metabolism, as well as a variety of diseases. In this article, we will comprehensively review the biological functions of COUP-TFII and its underlying mechanism in various developmental processes and diseases. In addition, we will briefly summarize some of the current findings of COUP-TFI.
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Affiliation(s)
- Fu-Jung Lin
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Texas 77030, USA.
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11
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Limsukon A, Barack BM, Soo Hoo GW. Images in radiology. Can't take a deep breath. Am J Med 2008; 121:1055-7. [PMID: 19028200 DOI: 10.1016/j.amjmed.2008.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Revised: 09/04/2008] [Accepted: 09/04/2008] [Indexed: 11/15/2022]
Affiliation(s)
- Atikun Limsukon
- Division of Pulmonary and Critical Care Medicine, Cedars-Sinai Medical Center, Los Angeles, Calif., USA.
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12
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Death due to late-presenting congenital diaphragmatic hernia in a 2-year-old child. Am J Forensic Med Pathol 2008; 29:75-9. [PMID: 19749623 DOI: 10.1097/paf.0b013e318165c09f] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Congenital diaphragmatic hernia (CDH) is classically regarded as a neonatal defect presenting with respiratory distress; however, not all CDH will present in this manner. Unlike newborn deaths related to CDH, where the mechanism of death is respiratory in nature, the mechanism of death in late-presenting CDH is not always due to respiratory compromise. In this case report, we present a death occurring in a 2 1/2-year-old child who presented to the emergency department with complaints of abdominal pain and emesis, and then rapidly decompensated and died. Autopsy revealed a CDH, with herniation of abdominal contents into the left thoracic cavity, with associated gastric volvulus, necrosis, and rupture.
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13
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Marcus KA, Halbertsma FJJ, Severijnen RSVM. Presentation of congenital diaphragmatic hernia after the neonatal period. Clin Pediatr (Phila) 2008; 47:171-5. [PMID: 17766578 DOI: 10.1177/0009922807306021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Karen A Marcus
- Department of Paediatrics, Máxima Medical Centre Veldhoven, Veldoven, The Netherlands.
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14
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Losanoff JE, Richman BW, Jones JW. Morgagni hernia and colonic malrotation in an adult. Int J Clin Pract 2007; 61:692-4. [PMID: 17394442 DOI: 10.1111/j.1742-1241.2006.01083.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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15
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Englert C, Helmke K, Richter A, Beckmann M, Rogiers X, Burdelski M, Ganschow R. Diaphragmatic Hernia Resulting in Enterothorax Following Pediatric Liver Transplantation: A Rare Complication. Transplantation 2006; 82:574-6. [PMID: 16926604 DOI: 10.1097/01.tp.0000231709.63721.5c] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Diaphragmatic hernia is a rare complication following solid organ transplantation. We here report three pediatric patients suffering from posttransplant enterothorax. One patient with biliary atresia presented with clinical signs of peritonitis without showing pulmonary symptoms four weeks following liver transplantation. The second patient was admitted with suspected pneumonia, whereas the third patient presented with recurrent abdominal pain over weeks and physical examination revealed the unexpected diagnosis of enterothorax. All patients received split liver transplants. Unspecific clinical signs mislead to suspected infectious complication under immunosuppression. No apparent risk factors for diaphragmatic hernia could be identified. Diaphragmatic hernia can present with a variety of atypical clinical symptoms. Severe or prolonged abdominal complains should lead to x-ray examination. We speculate that the split liver technique used in our center could lead to this rare complication due to the different anatomic position of the liver transplant in the abdomen.
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Affiliation(s)
- Cornelia Englert
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Germany.
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16
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You LR, Takamoto N, Yu CT, Tanaka T, Kodama T, Demayo FJ, Tsai SY, Tsai MJ. Mouse lacking COUP-TFII as an animal model of Bochdalek-type congenital diaphragmatic hernia. Proc Natl Acad Sci U S A 2005; 102:16351-6. [PMID: 16251273 PMCID: PMC1283449 DOI: 10.1073/pnas.0507832102] [Citation(s) in RCA: 132] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Congenital diaphragmatic hernia (CDH), a life-threatening anomaly, is a major cause of pediatric mortality. Although the disease was described >350 years ago, the etiology of CDH is poorly understood. Here, we show that tissue-specific null mutants of COUP-TFII exhibit Bochdalek-type CDH, the most common form of CDH. COUP-TFII, a member of orphan nuclear receptors, is expressed in regions critical for the formation of the diaphragm during embryonic development. Ablation of COUP-TFII in the foregut mesenchyme, including the posthepatic mesenchymal plate (PHMP), results in the malformation of the diaphragm and the failure of appropriate attachment of the PHMP to the body wall. Thus, both the stomach and liver enter the thoracic cavity, leading to lung hypoplasia and neonatal death. Recently a minimally deleted region for CDH has been identified on chromosome 15q26.1-26.2 by CGH array and FISH analysis. COUP-TFII is one of the four known genes residing within this critical region. Our finding suggests that COUP-TFII is a likely contributor to the formation of CDH in individuals with 15q deletions, and it may also be a potential contributor to some other Bochdalek-type of CDH.
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Affiliation(s)
- Li-Ru You
- Department of Molecular and Cellular Biology and Developmental Biological Program, Baylor College of Medicine, Houston, TX 77030, USA
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17
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Yuan W, Rao Y, Babiuk RP, Greer JJ, Wu JY, Ornitz DM. A genetic model for a central (septum transversum) congenital diaphragmatic hernia in mice lacking Slit3. Proc Natl Acad Sci U S A 2003; 100:5217-22. [PMID: 12702769 PMCID: PMC154325 DOI: 10.1073/pnas.0730709100] [Citation(s) in RCA: 107] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2002] [Accepted: 02/05/2003] [Indexed: 01/13/2023] Open
Abstract
Congenital diaphragmatic hernia (CDH) is a significant cause of pediatric mortality in humans with a heterogeneous and poorly understood etiology. Here we show that mice lacking Slit3 developed a central (septum transversum) CDH. Slit3 encodes a member of the Slit family of guidance molecules and is expressed predominantly in the mesothelium of the diaphragm during embryonic development. In Slit3 null mice, the central tendon region of the diaphragm fails to separate from liver tissue because of abnormalities in morphogenesis. The CDH progresses through continuous growth of the liver into the thoracic cavity. This study establishes the first genetic model for CDH and identifies a previously unsuspected role for Slit3 in regulating the development of the diaphragm.
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Affiliation(s)
- Wenlin Yuan
- Department of Molecular Biology and Pharmacology, Washington University School of Medicine, St. Louis, MO 63110, USA
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18
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Oh A, Gulati G, Sherman ML, Golub R, Kutin N. Bilateral eventration of the diaphragm with perforated gastric volvulus in an adolescent. J Pediatr Surg 2000; 35:1824-6. [PMID: 11101746 DOI: 10.1053/jpsu.2000.19271] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Bilateral congenital eventration of the diaphragm almost uniformly presents in infancy with respiratory compromise and is associated with a high mortality rate. Delayed presentation of diaphragmatic eventration in older children and adults may be associated with acute gastric volvulus. Thus, any patient with abdominal pain, vomiting, or nonspecific gastrointestinal symptoms in association with abnormal diaphragmatic findings on chest x-ray should undergo further diagnostic workup with upper gastrointestinal series or computed tomography (CT) scan. Treatment of gastric volvulus requires immediate surgical repair to prevent subsequent necrosis and perforation. The authors describe a case report of bilateral congenital diaphragmatic eventration complicated by a perforated gastric volvulus in a 13-year-old boy. Emergent reduction of the volvulus, closure of the perforated stomach, plication of the diaphragm, and placement of gastrostomy was performed successfully.
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Affiliation(s)
- A Oh
- Flushing Hospital Medical Center, Flushing, NY, USA
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19
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Katz S, Kidron D, Litmanovitz I, Erez I, Dolfin Z. Fibrous fusion between the liver and the lung: an unusual complication of right congenital diaphragmatic hernia. J Pediatr Surg 1998; 33:766-7. [PMID: 9607495 DOI: 10.1016/s0022-3468(98)90214-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A congenital right diaphragmatic hernia was diagnosed in a full-term newborn who presented with respiratory distress at the age of 10 hours. The patient required respiratory support, and was operated on at age 6 days. During surgery, a central defect of the diaphragm was found. The herniated liver was only partially reducible because of intrathoracic adhesions. The patient died at 10 days of age as a result of persistent fetal circulation. Postmortem pathological examination demonstrated a central diaphragmatic defect and a nonseparable fibrous fusion between the liver and the lung.
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Affiliation(s)
- S Katz
- Department of Pediatric Surgery, Sapir Medical Center, Meir General Hospital, Kfar Saba, Israel
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20
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Del Castillo D, Sanchez J, Hernandez M, Sanchez A, Domenech J, Jara J. Morgagni's hernia resolved by laparoscopic surgery. J Laparoendosc Adv Surg Tech A 1998; 8:105-8. [PMID: 9617972 DOI: 10.1089/lap.1998.8.105] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Morgagni's hernias represent between 2 and 4% of the whole of nontraumatic diaphragmatic hernias in the adult, and the treatment (even with minimal symptoms) is always with surgery. We present the case of a 50-year-old woman with an oppressive, postprandial discomfort in the right side of her thorax and with increased pain when supine. The x-ray examination indicated a large portion of transverse colon inside the thoracic cavity. Once the diagnosis of Morgagni's hernia had been obtained, she was scheduled for laparoscopic surgery to reduce the hernia and to reconstruct the defect of the diaphragm using a polypropylene mesh.
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Affiliation(s)
- D Del Castillo
- Department of Surgery, University Hospital of St. Joan, Rovira i Virgili University School of Medicine and Health Sciences (C/Sant Joan s/n), Reus, Spain
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Urushihara N, Nakagawa Y, Kawashima K, Fukazawa T, Watanabe Y, Todani T. Congenital right diaphragmatic hernias through posterolateral and anterolateral defects associated with extralobar pulmonary sequestration: a case report. J Pediatr Surg 1997; 32:101-2. [PMID: 9021582 DOI: 10.1016/s0022-3468(97)90106-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Multiple diaphragmatic hernias in the unilateral diaphragm are extremely rare. The authors report a neonate with diaphragmatic hernias through two defects in the right diaphragm: a posterolateral defect without a hernia sac and an anterolateral defect with one. After excision of the anterolateral hernia sac, each defect was closed. Histology studies showed extralobar pulmonary sequestration in the removed hernia sac. The presence of sequestrated pulmonary tissue indicates the possibility of interference with the closure of the pleuroperitoneal canal and muscularization in the diaphragm, which may result in multiple defects.
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Affiliation(s)
- N Urushihara
- Department of Pediatric Surgery, National Iwakunt Hospital, Yamaguchi, Japan
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