1
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Taheriniya A, Maghsoudi MR, Chaghamirzayi P. Incidental discovery of a giant congenital diaphragmatic hernia in an adult: A case report and literature review. Int J Surg Case Rep 2024; 121:109969. [PMID: 38943942 PMCID: PMC11261402 DOI: 10.1016/j.ijscr.2024.109969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/23/2024] [Accepted: 06/26/2024] [Indexed: 07/01/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Congenital diaphragmatic hernia (CDH) is rare, occurring in 1 in 2000 to 4000 live births, and is typically diagnosed in neonates. Bochdalek hernia is the most common type, usually presenting as a left-sided posterolateral defect. Adult presentations of CDH are uncommon and often incidental. This report discusses a young adult with an undiagnosed CDH, emphasizing the importance of clinical awareness. CASE PRESENTATION A 26-year-old man presented with flu-like symptoms and stable vital signs. He reported chronic postprandial shortness of breath that improved with standing. Physical examination revealed decreased breath sounds on the left side. A chest X-ray identified a left diaphragmatic hernia, confirmed by spiral chest computed tomography. Although advised to undergo surgery, the patient opted for discharge against medical advice. CLINICAL DISCUSSION Bochdalek hernia, comprising over 95 % of CDH cases, is usually left-sided due to a defect in the pleuroperitoneal membrane. Adults with CDH often present with nonspecific symptoms or the condition is discovered incidentally. Our patient adapted to his symptoms by standing after meals, which provided relief. Surgical intervention is recommended to prevent organ damage, with various techniques available, including open and endoscopic surgery. This case highlights the necessity of clinical vigilance in diagnosing CDH in adults. CONCLUSION Adult congenital diaphragmatic hernia, though rare, requires prompt surgical treatment to prevent organ damage. Recognizing subtle symptoms is crucial for diagnosis. This report contributes to the limited literature on adult-diagnosed CDH, stressing the need for clinical awareness and timely management.
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Affiliation(s)
- Ali Taheriniya
- Department of Emergency Medicine, Alborz University of Medical Science, Karaj, Iran
| | | | - Pouria Chaghamirzayi
- Clinical Research Development Unit of Shahid Madani Hospital, Alborz University of Medical Science, Karaj, Iran.
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2
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Torres-Jurado MJ, Gómez-Hernández MT, Valera-Montiel AE, Vicente-González L, Abdel-Lah-Fernández O, Parreño-Manchado FC, Jiménez-López MF. Non-hiatal diaphragmatic hernias: results of transabdominal and transthoracic surgical approaches at a fourth-level hospital. Hernia 2024:10.1007/s10029-024-03065-1. [PMID: 38767717 DOI: 10.1007/s10029-024-03065-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/28/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVE The objective of this study is to elucidate the clinical and demographic profiles, as well as perioperative outcomes, of patients undergoing surgery for non-hiatal diaphragmatic hernias. Additionally, it aims to analyse these outcomes based on the surgical approach employed (transthoracic versus transabdominal). METHODS This retrospective, observational study was conducted at a single center and involved patients diagnosed with non-hiatal diaphragmatic hernia who underwent either emergency or elective surgery between July 2007 and March 2023. Clinical characteristics and perioperative outcomes of these patients were compared using appropriate statistical tests.The research protocol for this observational, retrospective, and comparative study followed the Declaration of Helsinki's ethical requirements. The need for Clinical Research Ethics Committee approval was waived according to our institutional law because the study was a retrospective cohort study based on anonymous data of patients. Informed consent was waived because this study involved the secondary analysis of patient medical records. Additionally, this study followed the STROBE guidelines for reporting observational studies. RESULTS The analysis included 22 patients being 59.1% men, with median age of 61 years. The predominant clinical presentation was restrictive lung disease (40.9%). The majority of cases (68%) had traumatic aetiology with a median defect size of 4 cm (range of 3-8 cm). Elective surgery was performed in 15 cases (68.1%) and transthoracic approach was employed in 13 patients (54.5%). Postoperative major morbidity reached 27.2% and mortality within 30 days was 9.1%. Emergency surgeries accounted for 44.4% of transabdominal interventions, compared to 23% in the transthoracic subgroup (p = 0.376). There were no statistically significant differences between the transabdominal and trasnthoracic approaches in terms of global postoperative complications (88.8% vs. 84.6%, p = 1), major complications (44.4% vs 15.4%, p = 0.734), mortality (11.1% v 7.6%, p = 1) and recurrence (11.1% vs 7.6%, p = 1). Postoperative stay was significantly shorter in the transthoracic subgroup (6 days vs. 14 days, p = 0.011). CONCLUSIONS Non-hiatal diaphragmatic hernias are characterized by significant postoperative major morbidity and mortality rates, standing at 27.2% and 9.1%, respectively, accompanied by a recurrence rate of 9.1%. Both transthoracic and transabdominal approaches demonstrate comparable short- and long-term outcomes.
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Affiliation(s)
| | | | - Andrés E Valera-Montiel
- General and Digestive Surgery Department, University Hospital of Salamanca, Salamanca, Spain
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3
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Hashmi MU, Ullah K, Tariq A, Sarwar M, Khan IH. Morgagni-Larrey Hernia: A Possible Cause of Recurrent Lower Respiratory Tract Infections. Cureus 2019; 11:e4035. [PMID: 32181060 PMCID: PMC7053801 DOI: 10.7759/cureus.4035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Morgagni-Larrey hernia is an exceedingly rare presentation of congenital diaphragmatic hernia. Despite its rarity, it is associated with significant risk of morbidity and mortality. Herein, we describe a unique case report of an elderly woman who presented with left-sided chest pain, dyspnea, and chronic history of recurrent respiratory tract infections. On the basis of her medical history, general physical examination and imaging studies, she was operated for a presumptive diagnosis of thymolipoma. However, the intra-operative findings revealed that it was an unusual variant of a diaphragmatic hernia and the hernia sac appeared through the retrosternal foramen of Morgagni. Hence we concluded that it was a Morgagni-Larrey hernia compressing the lungs and heart. Consequently, the hernia was reduced and the defect was repaired. During the postoperative period, the patient had an uneventful recovery. To conclude, the possibility of a Morgagni-Larrey hernia should be strongly considered while evaluating a patient with recurrent chest infections, dyspnea, and vague chest pain.
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Affiliation(s)
| | - Kaleem Ullah
- Thoracic Surgery, Nishtar Medical University Hospital, Multan, PAK
| | - Ayesha Tariq
- Thoracic Surgery, Nishtar Medical University Hospital, Multan, PAK
| | - Mohsin Sarwar
- Internal Medicine, Shifa College of Medicine, Islamabad, PAK
| | - Iftikhar H Khan
- Thoracic Surgery, Nishtar Medical University Hospital, Multan, PAK
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4
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Ciancarella P, Fazzari F, Montano V, Guglielmo M, Pontone G. A huge Morgagni hernia with compression of the right ventricle. J Saudi Heart Assoc 2018; 30:143-146. [PMID: 29910585 PMCID: PMC6000895 DOI: 10.1016/j.jsha.2017.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 09/14/2017] [Accepted: 09/26/2017] [Indexed: 11/29/2022] Open
Abstract
A 21 year old male with no relevant medical history presented to our Institution for further assessments of a right paracardiac mass founded on a chest X-ray. Chest computed tomography revealed a wide median defect of the diaphragm at the level of xiphoid process of the sternum, with the herniation of omental fat tissue in the mediastinum. Cardiac magnetic resonance confirmed the presence of a huge hernia originating from the foramen of Morgagni (sterno-costal hiatus), displacing the heart leftwards and posteriorly and compressing the right ventricle (RV), giving to it a tubular shape.The signal characteristics were typical of fat tissue, with hyperintense signal in T1 and T2 weighted black blood images and homogeneus signal suppression on STIR T2 black blood images. Short axis real time cine images, performed during deep inspiration, showed an early diastolic ventricular septal bounce, with flattening of the interventricular septum during mid-late diastole: they represented signs of diastolic dysfunction of the right ventricle, resembling a sort of “pseudo-constrictive” pathophysiological model. The patient was thus referred to surgical repair of the diaphragmatic defect.
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Affiliation(s)
- Paolo Ciancarella
- Department of Radiology and Bioimaging, Bambino Gesù Children Hospital-IRCCS, Piazza di Sant'Onofrio 4, 00165 Rome, Italy
| | - Fabio Fazzari
- Division of Cardiology II, Department of Internal Medicine and Cardiovascular Diseases, University Hospital "Paolo Giaccone", Via del vespro 129, 90127 Palermo, ItalybItaly
| | - Valentina Montano
- Pediatric Urological Unit, Department of Sciences for Health Promotion and Mother-Child Care "G. D'Alessandro", University Hospital "Paolo Giaccone", Via Giordano 3, 90127 Palermo, ItalycItaly
| | - Marco Guglielmo
- Centro Cardiologico Monzino, IRCCS, Via Carlo Parea 4, 20138 Milan, ItalydItaly
| | - Gianluca Pontone
- Centro Cardiologico Monzino, IRCCS, Via Carlo Parea 4, 20138 Milan, ItalydItaly
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5
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Souza Neto JRNDE, Branco É, Giese EG, Lima ARDE. Morphological Characterization of Diaphragm in Common Squirrel Monkey (Saimiri sciureus). AN ACAD BRAS CIENC 2018; 90:169-178. [PMID: 29466481 DOI: 10.1590/0001-3765201820170167] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 09/11/2017] [Indexed: 11/21/2022] Open
Abstract
The wall of the diaphragm can be affected by congenital or acquired alterations which allow the passage of viscera between the abdominal and chest cavities, allowing the formation of a diaphragmatic hernia. We characterized morphology and performed biometrics of the diaphragm in the common squirrel monkey Saimiri sciureus. After fixation, muscle fragments were collected and processed for optical microscopy. In this species the diaphragm muscle is attached to the lung by phrenopericardial ligament. It is also connected to the liver via the coronary and falciform ligaments. The muscle is composed of three segments in total: 1) sternal; 2) costal, and 3) a segment consisting of right and left diaphragmatic pillars. The anatomical structures analyzed were similar to those reported for other mammals. Histological analysis revealed stable, organized muscle fibers with alternation of light and dark streaks, indicating transverse striation.
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Affiliation(s)
- José Ricardo N DE Souza Neto
- Laboratório de Pesquisa Morfológica Animal/LaPMA, Faculdade de Medicina Veterinária, Universidade Federal Rural da Amazônia/UFRA, Avenida Presidente Tancredo Neves, 2501, Montese, 66077-530 Belém, PA, Brazil
| | - Érika Branco
- Laboratório de Pesquisa Morfológica Animal/LaPMA, Faculdade de Medicina Veterinária, Universidade Federal Rural da Amazônia/UFRA, Avenida Presidente Tancredo Neves, 2501, Montese, 66077-530 Belém, PA, Brazil
| | - Elane G Giese
- Laboratório de Histologia e Embriologia Animal/LHEA, Faculdade de Medicina Veterinária, Universidade Federal Rural da Amazônia/UFRA, Avenida Presidente Tancredo Neves, 2501, Montese, 66077-530 Belém, PA, Brazil
| | - Ana Rita DE Lima
- Laboratório de Histologia e Embriologia Animal/LHEA, Faculdade de Medicina Veterinária, Universidade Federal Rural da Amazônia/UFRA, Avenida Presidente Tancredo Neves, 2501, Montese, 66077-530 Belém, PA, Brazil
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6
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Susmallian S, Raziel A. A Rare Case of Bochdalek Hernia with Concomitant Para-Esophageal Hernia, Repaired Laparoscopically in an Octogenarian. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:1261-1265. [PMID: 29184050 PMCID: PMC5716375 DOI: 10.12659/ajcr.906225] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Patient: Male, 81 Final Diagnosis: Bochdalex hernia Symptoms: Chest pain • vomiting Medication: — Clinical Procedure: Laparoscopic repair of both diaphragmatic hernias Specialty: Surgery
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7
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A Rare Case of Bilateral Morgagni's Hernia with Intestinal Obstruction and Malrotation of the Gut in an Adult Patient with Severe Osteogenesis Imperfecta Presenting as Severe Respiratory Distress. Indian J Surg 2017; 79:158-159. [PMID: 28442844 DOI: 10.1007/s12262-016-1456-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 02/10/2016] [Indexed: 10/22/2022] Open
Abstract
Osteogenesis imperfecta (OI) is associated with congenital inguinal hernia that can occur due to genetic mutation. Morgagni's hernia is a rare congenital diaphragmatic herniation and is usually diagnosed in childhood. We present a case of an 18-year-old male presenting with bilateral Morgagni's hernia with intestinal obstruction with osteogenesis imperfecta with malrotation of the gut.
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8
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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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9
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Mambo NC. Nontraumatic Liver Herniation through a Right–Sided Congenital Diaphragmatic Hernia of Morgagni: An Autopsy Case Report with a Review of Liver Herniations through the Defect and a Review of the Defect. Acad Forensic Pathol 2014. [DOI: 10.23907/2014.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Congenital diaphragmatic hernia of Morgagni (CMH) is a rare developmental defect that develops during the development of the human diaphragm. It is usually right-sided and tends to produce symptoms in later life when abdominal viscera herniate into the chest cavities. Herniations of the liver through this defect into the chest cavities are rare and are often not clinically suspected even when they are associated with symptoms. The amounts of liver tissue involved are usually small, do not cause symptoms and are often an incidental finding during imaging studies of the chest for unrelated symptoms. This case report documents a clinically unrecognized incidental herniation of the liver into the right chest cavity through a CMH. The report also reviews previously reported cases of liver herniations through a CMH and the possible causes of the defect.
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Affiliation(s)
- Nobby C. Mambo
- Galveston County, Texas City, TX, and University of Texas Medical Branch, Galveston, TX
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10
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Abraham V, Myla Y, Verghese S, Chandran BS. Morgagni-larrey hernia- a review of 20 cases. Indian J Surg 2012; 74:391-5. [PMID: 24082592 PMCID: PMC3477412 DOI: 10.1007/s12262-012-0431-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Accepted: 03/02/2012] [Indexed: 10/28/2022] Open
Abstract
Morgagni-Larrey hernia is an uncommon entity. The majority of the literature describes hernia occurring mostly on the right side, a few on the left side and rarely bilateral. Retrospective chart review was done for the patients with the diagnosis of adult diaphragmatic hernia from January 1997 to December 2010. Post-operative course was evaluated for outcome, morbidity and mortality. Out of 20 patients, 13 (65 %) were males and 7 (35 %) were females. Their age ranged from 17 to 50 years (mean = 29.6). Abdominal discomfort was the most common presentation. Eight patients (40 %) were asymptomatic at presentation. Plain X-Ray chest was done for all. Ten patients (50 %) underwent suture repair, 6 (30 %) had mesh placement and the other 4 (25 %) underwent both: suture repair buttressed with mesh. Volvulus of stomach was noted in 5 (25 %) cases. All patients had left sided hernia. There was insignificant morbidity and no mortality. There was no recurrence in 16 patients followed up for a mean duration of 20 months (range = 8 to 32 months). In Morgagni-Larrey hernia, abdominal approach gives good accessibility to reduce the hernia and to undertake repair. When complicated with incarceration, perforation, gangrene or volvulus of the herniated bowel; this can be dealt with ease. Plain X Ray of the chest is fairly accurate in suggesting the diagnosis of Morgagni-Larrey hernia.
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Affiliation(s)
- Vijay Abraham
- Upper GI Surgery unit, Department of Surgery, Christian Medical College and Hospital, Vellore, TN 632004 India
| | - Yacob Myla
- Upper GI Surgery unit, Department of Surgery, Christian Medical College and Hospital, Vellore, TN 632004 India
| | - Sam Verghese
- Upper GI Surgery unit, Department of Surgery, Christian Medical College and Hospital, Vellore, TN 632004 India
| | - B. Sudhakar Chandran
- Upper GI Surgery unit, Department of Surgery, Christian Medical College and Hospital, Vellore, TN 632004 India
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11
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Tamponnade néonatale par hernie de Morgagni. Arch Pediatr 2010; 17:1465-8. [DOI: 10.1016/j.arcped.2010.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2009] [Revised: 10/13/2009] [Accepted: 07/13/2010] [Indexed: 11/20/2022]
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12
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Rai SP, Kamath M, Shetty A, Shenoy S, Kumar A. Symptomatic Morgagni's hernia in an elderly patient. J Emerg Trauma Shock 2010; 3:89-91. [PMID: 20165730 PMCID: PMC2823152 DOI: 10.4103/0974-2700.58654] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Accepted: 02/17/2009] [Indexed: 11/05/2022] Open
Abstract
Hernia of Morgagni occurs through an anterior defect in the diaphragm. Symptoms of these hernias are attributable to the herniated viscera. In our case, there was partial obstruction due to herniation of the distal stomach and pylorus into the right hemithorax that was reduced surgically through a right thoracolapaorotomy. Of special emphasis are the various modalities used to diagnose this condition in our case.
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Affiliation(s)
- Santosh Pv Rai
- Department of Radiodiagnosis, KMC Hospital, Attavar, Mangalore - 575 001, Karnataka, India
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13
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Rashid F, Chaparala R, Ahmed J, Iftikhar SY. Atypical right diaphragmatic hernia (hernia of Morgagni), spigelian hernia and epigastric hernia in a patient with Williams syndrome: a case report. J Med Case Rep 2009; 3:7. [PMID: 19128471 PMCID: PMC2630954 DOI: 10.1186/1752-1947-3-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2008] [Accepted: 01/07/2009] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Williams syndrome is rare genetic disorder resulting in neurodevelopmental problems. Hernias of the foramen of Morgagni are rare diaphragmatic hernias and they mostly present on the right side, in the anterior mediastinum. They are usually asymptomatic and are difficult to diagnose, especially in patients with learning disabilities. CASE PRESENTATION This 49-year-old woman with Williams syndrome, cognitive impairment and aortic stenosis presented to physicians with right-sided chest pain. She had previously undergone repair of her right spigelian and epigastric hernia. Her abdominal examination was unremarkable. Chest X-ray suggested right-sided diaphragmatic hernia and pleural effusion for which she received treatment. The computed tomography scan showed a diaphragmatic hernia with some collapse/consolidation of the adjacent lung. Furthermore, the patient had aortic stenosis and was high risk for anaesthesia (ASA grade 3). She underwent successful laparoscopic repair of her congenital diaphragmatic hernia leading to a quick and uneventful postoperative recovery. CONCLUSION These multiple hernias suggest that patients with Williams syndrome may have some connective tissue disorder which makes them prone to develop hernias especially associated with those parts of the body which may have intracavity pressure variations like the abdomen. Diaphragmatic hernia may be the cause of chest pain in these patients. A computed tomography scan helps in early diagnosis, and laparoscopic repair helps in prevention of further complications, and leads to quick recovery especially in patients with learning disabilities. In the presence of significant comorbidities, a less invasive operative procedure with quick recovery becomes advisable.
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Affiliation(s)
- Farhan Rashid
- Division of GI Surgery, Clinical Sciences Wing, The Medical School, Derby City General Hospital, Uttoxeter Road, Derby, DE22 3DT, UK.
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14
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Arriba-Méndez S, Rupérez Peña S, Ballesteros Gómez F, Marrero Calvo M, Ruiz Pérez M. Hernia de Morgagni izquierda con contenido hepático. An Pediatr (Barc) 2008; 69:486-7. [DOI: 10.1157/13128007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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15
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Dapri G, Himpens J, Hainaux B, Roman A, Stevens E, Capelluto E, Germay O, Cadière GB. Surgical technique and complications during laparoscopic repair of diaphragmatic hernias. Hernia 2006; 11:179-83. [PMID: 17131071 DOI: 10.1007/s10029-006-0161-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2006] [Accepted: 10/12/2006] [Indexed: 10/23/2022]
Abstract
Diaphragmatic hernias can present as retrocostoxiphoid hernias (RCXH) or diaphragmatic dome hernias. The RCXH include the Larrey hernia (LH), the Morgagni hernia (MH), and the Larrey-Morgagni hernia (LMH). These congenital hernias are usually asymptomatic, and the diagnosis is simplified by two exams: chest X-ray, and thoraco-abdominal computed tomography (CT) scan. The potential risk in this condition is small-bowel incarceration in the hernia defect and subsequent obstruction. We report two cases of LH and one case of LMH treated by laparoscopy between February 2004 and October 2005, with a review of the surgical techniques. Two different laparoscopic techniques were used: the tension-free technique, and resection of the hernia sac with closure of the defect and reinforcement by prosthesis. One patient presented a postoperative cardiac tamponade due to a clip-induced bleeding of an epicardial artery at the inferior surface of the heart. Treatment by laparoscopy is feasible, but a consensus regarding the best laparoscopic repair is needed.
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Affiliation(s)
- G Dapri
- Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium
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16
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Buelta González C, Fernández Salazar L, Velayos Jiménez B, Huidobro A, Jimeno Carruez A. Insuficiencia respiratoria, vómitos y diarrea en paciente con síndrome de Down. Rev Clin Esp 2006; 206:519-20. [PMID: 17129523 DOI: 10.1157/13094905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- C Buelta González
- Servicios de Medicina Interna, Hospital Clínico de Valladolid, España
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17
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Abstract
Congenital diaphragmatic hernia (CDH) affects 1 in every 2,000 to 4,000 live births. Many infants with this condition are diagnosed antenatally through routine ultrasound screening. Nearly 90 percent present at delivery with severe respiratory distress requiring intubation. Many of these infants develop persistent pulmonary hypertension of the newborn due to hypoplasia of the affected lung. The survival of infants with CDH is limited by the degree of pulmonary hypoplasia and requires sophisticated medical technology such as high-frequency ventilation and inhaled nitric oxide. Some infants also require treatment with extracoporeal membrane oxygenation. This article gives details of two cases of CDH in which the presentation was atypical. The more subtle presentation is discussed, as well as the embryology and pathophysiology of CDH and the possibility of associated anomalies. Clinical management and impact on the family are outlined.
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MESH Headings
- Extracorporeal Membrane Oxygenation
- Hernia, Diaphragmatic/diagnosis
- Hernia, Diaphragmatic/epidemiology
- Hernia, Diaphragmatic/therapy
- Hernias, Diaphragmatic, Congenital
- High-Frequency Jet Ventilation
- Humans
- Infant Mortality
- Infant, Newborn
- Intensive Care, Neonatal/methods
- Intubation, Intratracheal
- Morbidity
- Neonatal Nursing/organization & administration
- Neonatal Screening
- Nurse's Role
- Nursing Assessment
- Parents/education
- Parents/psychology
- Persistent Fetal Circulation Syndrome/etiology
- Professional-Family Relations
- Respiratory Distress Syndrome, Newborn/etiology
- Survival Rate
- Ultrasonography, Prenatal/methods
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Affiliation(s)
- Barbara Puckett
- Saskatoon District Health, Royal University Hospital, Canada.
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18
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Rodríguez-Hermosa JI, Pujadas M, Ruiz B, Gironès J, Roig J, Fort E, Hombrados M, Codina-Cazador A. Hernia diafragmática de Bochdalek en el adulto. Cir Esp 2004. [DOI: 10.1016/s0009-739x(04)78962-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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