ABSTRACT
Blunt traumatic diaphragmatic ruptures are uncommon yet associated with high mortality. They occur due to blunt or penetrating thoraco-abdominal injury. Diagnosis is often missed, and a high index of suspicion is vital. They may present acutely or delayed as respiratory distress or obstruction. They can be managed through a laparotomy or a thoracotomy and in the present day with minimal access surgery. We report an interesting case of blunt traumatic diaphragmatic hernia in a 48-year-old man presenting after abdomino-thoracic injury due to fall from height. He had herniation of the colon and stomach. Through a left subcostal incision, the herniated organs were reduced, and the diaphragmatic defect closed with prolene suture.
Subject(s)
Abdominal Injuries/complications , Abdominal Injuries/etiology , Accidental Falls/epidemiology , Hernia, Diaphragmatic/diagnosis , Hernia, Diaphragmatic/epidemiology , Hernia, Diaphragmatic/etiology , Hernia, Diaphragmatic/surgery , Humans , Male , Middle Aged , Thoracic Injuries/complications , Thoracic Injuries/etiology , /complications , /etiologyABSTRACT
Transdiaphragmatic intercostal hernia is uncommon and mostly related to blunt or penetrating trauma. We report three similar cases of cough-induced transdiaphragmatic intercostal hernia, highlighting the anatomic findings obtained with different imaging modalities (radiography, ultrasonography, CT, and magnetic resonance) in each of the cases.
Hérnias intercostais transdiafragmáticas são eventos raros e são geralmente relacionadas a traumas abertos ou fechados, com risco de complicações. Relatamos três casos semelhantes, decorrentes de crises de tosse, destacando o aspecto das alterações anatômicas nos exames de imagem obtidos em cada situação (radiografia, ultrassonografia, TC e ressonância magnética).
Subject(s)
Aged , Humans , Male , Middle Aged , Cough/complications , Hernia, Abdominal/diagnosis , Hernia, Diaphragmatic/diagnosis , Thoracic Wall/injuries , Diagnostic Imaging/methods , Hernia, Abdominal/etiology , Hernia, Abdominal/surgery , Hernia, Diaphragmatic/etiology , Hernia, Diaphragmatic/surgery , ThoracotomyABSTRACT
Because of its safety and treatment effectiveness, the popularity of radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC) has gradually increased. However, some serious complications of RFA such as hepatic infarction, bowel perforation, and tumor seeding have been reported. Recently, we experienced a case of diaphragmatic hernia after RFA for HCC. A 61-year-old man with alcoholic cirrhosis was diagnosed with a 1.0 cm sized HCC in segment (S) 5 and a 1.3 cm sized HCC in S 8 of the liver. He was treated by transarterial chemoembolization and RFA. After RFA, an abdominal CT revealed a diaphragmatic defect with herniating mesentery. Twenty-two months after the RFA, the chest CT showed the diaphragmatic defect with herniating colon and mesentery. Because he had no symptoms, and surgical repair for the diaphragmatic hernia would be a high risk operation for him, we decided to treat the patient conservatively. For its great rarity, we report this case with a review of the literature.
Subject(s)
Humans , Male , Middle Aged , Carcinoma, Hepatocellular/diagnosis , Catheter Ablation/adverse effects , Chemoembolization, Therapeutic , Hernia, Diaphragmatic/etiology , Liver Cirrhosis, Alcoholic/complications , Liver Neoplasms/diagnosis , Magnetic Resonance Imaging , Tomography, X-Ray ComputedABSTRACT
Simultaneous occurrence of traumatic abdominal wall hernia (TAWH) and traumatic diaphragmatic hernia (TDH) is uncommon. Our report documents the rare delayed presentation of simultaneous occurrence of TAWH and TDH in a patient who sustained a bicycle handlebar injury as a consequence of the bicycle he was riding colliding with a motorbike in a road-traffic accident. Excellent outcome could be achieved in this patient with surgical repair without requiring the use of a mesh.
Subject(s)
Abdominal Injuries/complications , Accidents, Traffic , Bicycling/injuries , Diaphragm/injuries , Hernia, Abdominal/diagnosis , Hernia, Abdominal/etiology , Hernia, Diaphragmatic/diagnosis , Hernia, Diaphragmatic/etiology , Humans , Male , Middle AgedABSTRACT
Spontaneous acquired diaphragmatic hernia without any apparent history of trauma is a very rare condition and is very difficult to diagnose. We present a case of a 21-year-old male who presented with abdominal pain for one month and four episodes of vomiting for one day. Clinical suspicion, chest radiography with nasogastric tube in situ and computed tomography (CT) confirmed the diagnosis. The diaphragmatic defect was repaired surgically. The patient had an uneventful post-operative recovery.
Subject(s)
Adult , Hernia, Diaphragmatic/diagnosis , Hernia, Diaphragmatic/diagnostic imaging , Hernia, Diaphragmatic/surgery , Hernia, Diaphragmatic/etiology , Humans , Male , Thoracotomy , Tomography, X-Ray Computed , Weight Lifting/injuries , Young AdultABSTRACT
One case of transdiafragmatic intercostal hernia after intense coughing fit followed by rib fractures in patient with history of pneumonia is presented. He had a severe coughing fit, developed a right toracoabdominal hematoma and then a tumor that was gradually enlarging. Image exams confirmed the diagnosis. Treatment consisted of surgical repair with the use of a polypropylene prosthetic mesh. It is a rare type of hernia. Only four cases were found in literature. The sooner the disease is diagnosed and treated the better the prognoses will be since it will prevent hernia from strangulation and incarceration.
Subject(s)
Aged , Humans , Male , Cough/complications , Fractures, Spontaneous/complications , Hernia, Diaphragmatic/etiology , Rib Fractures/complications , RibsABSTRACT
A two-month-old girl was operated for a left-sided eventration of the diaphragm. At surgery, a mass representing an extralobar pulmonary sequestration (EPS) was found inferior to the left lobe of the lung and was excised. Histopathological examination of the resected specimen showed presence of a type II congenital cystic adenomatoid malformation (CCAM) within it. A review of the relevant literature is presented.
Subject(s)
Cystic Adenomatoid Malformation of Lung, Congenital/complications , Diaphragmatic Eventration/etiology , Female , Hernia, Diaphragmatic/etiology , Humans , InfantABSTRACT
Intercostal transdiaphragmatic hernia is a rarely reported lesion. Trauma is the commonest cause. We report a 75-year-old man who presented with transdiaphragmatic intercostal hernia due to chronic cough. He recovered after surgical repair.
Subject(s)
Aged , Chronic Disease , Cough/complications , Hernia, Diaphragmatic/etiology , Humans , MaleABSTRACT
A full-term, 3 kg baby girl developed early onset Candida tropicalis septicemia. The fungus was resistant to amphotericin B, fluconazole and itraconazole. She developed an acquired diaphragmatic hernia during the course of the infection. The possible association of the hernia with the fungal sepsis is discussed. She improved on treatment with 4-flucytosine and after being operated for the hernia.
Subject(s)
Candida tropicalis/isolation & purification , Candidiasis/complications , Drug Resistance, Fungal , Female , Fungemia/etiology , Hernia, Diaphragmatic/etiology , Humans , Infant, NewbornABSTRACT
La hernia diafragmática tras una esofagectomía transhatial es una complicación grave, especialmente cuando el diagnóstico es tardío. Presentamos el caso de una paciente que desarrolló una obstrucción completa del intestino delgado por una hernia diafragmática que se presentó tras una esofagectomía transhiatal. Paciente de 55 años, sexo femenino, que presentaba un carcinoma escamoso del tercio distal del esófago. Se realizó esofagectomía transhatial, con gatroplastía tubular transmediastínica posterior. En el 5º día postoperatorio presenta dolor torácico, vómitos, dificultad respiratoria y polipnea. El examen físico demostró clínica de derrame pleural en el hemitórax derecho. La radiografía de tórax mostró imagen de ocupación pleural en el hemitórax derecho y la radiología contrastada gastrointestinal mostró un asa de intestino delgado en hemitórax izquierdo. En la laparotomía exploradora se comprueba hernia a través del orificio hiatal ampliado y en hemitórax izquierdo con estrangulación y perforación de una asa yeyunal. Se realizó reducción del contenido herniario y enterorrafia. Evolución tórpidamente y egresa del hospital en buenas condiciones a los 57 días del postoperatorio
Subject(s)
Humans , Female , Middle Aged , Carcinoma, Squamous Cell/surgery , Esophageal Neoplasms , Esophagectomy , Hernia, Diaphragmatic/etiology , Gastroplasty , Hernia, Diaphragmatic/surgery , Hernia, Diaphragmatic/complications , Iatrogenic Disease , Intestinal Obstruction/etiology , Postoperative ComplicationsABSTRACT
Diaphragmatic plication is the procedure of choice for congenital diaphragmatic eventration. In the absence of complications, most newborns with eventration do well after plication and have normal long-term respiratory functions. However complications are rare. Recurrence, ipsilateral pneumothorax and rupture of the diaphragm have been reported in literature. We report a case of incarcerated diaphragmatic hernia in a two-year-old child who had undergone plication for eventration of the diaphragm at six months of age.
Subject(s)
Diaphragmatic Eventration/surgery , Hernia, Diaphragmatic/etiology , Humans , Infant , Male , Postoperative Complications/etiologyABSTRACT
O autor realizou revisao bibliografica sobre a terapia de reposicao com surfactante exogeno quanto a: estrategia de tratamento, diferentes preparacoes de surfactantes, doses, formas de administracao e intervalo entre as doses, e analisou outras formas de utilizacao da terapia na doenca da membrana hialina, como a associada ao CPAP nasal, bem como a outras patologias
Subject(s)
Humans , Hyaline Membrane Disease/therapy , Pulmonary Surfactants/administration & dosage , Adrenal Cortex Hormones/therapeutic use , Drug Combinations , Hernia, Diaphragmatic/etiology , Infant, Newborn , Meconium Aspiration Syndrome/therapy , Pulmonary Surfactants/therapeutic use , Respiration, Artificial , Respiratory Distress Syndrome, Newborn/etiology , Respiratory Distress Syndrome, Newborn/therapy , Risk FactorsABSTRACT
La hernia diafragmática congénita (HDC) continúa siendo una patología que pone en peligro la vida a pesar de los adelantos en su manejo. Las malformaciones congénitas asociadas resultan ser uno de los factores más importantes que contribuyen a elevar las tasas de mortalidad en estos pacientes. En este trabajo presentamos nuestra experiencia con relación a esta anomalía, la cual forma parte del Estudio Colaborativo Latinoamericano de Malformaciones Congénitas (ECLAMC), enfocado principalmente en la asociación de la HDC con otras malformaciones congénitas, y revisamos los aspectos relacionados con el patrón de herencia involucrado en los casos familiares de HDC. En este estudio encontramos que las malformaciones mayores, especialmente las cardíacas y un bajo peso al nacer confieren un mal pronóstico a los recién nacidos con HDC
Subject(s)
Humans , Male , Female , Infant, Newborn , Hernia, Diaphragmatic/congenital , Chromosome Aberrations/epidemiology , Hernia, Diaphragmatic/epidemiology , Hernia, Diaphragmatic/etiologyABSTRACT
Se revisa la incidencia, etiología, mecanismo de lesión, fases y presentación clínica, diagnóstico y tratamiento de la hernia diafragmática, en un estudio de cinco casos que se presentaron con una complicación y que fueron tratados en la Unidad de Emergencia, entre Mayo de 1996 y mayo de 1997
Subject(s)
Humans , Male , Female , Adult , Hernia, Diaphragmatic/complications , Hernia, Diaphragmatic/diagnosis , Hernia, Diaphragmatic/epidemiology , Hernia, Diaphragmatic/etiology , Hernia, Diaphragmatic/therapyABSTRACT
The authors report one case of retro-costoxiphoid hernia. After a short anatomical and etiological account, the authors insist on the diagnostic elements the most important of which are X - ray of the chest which may be completed by barium enema. Surgical repair is usually indicated as the risk in low and most easily performed by an upper abdominal approach
Subject(s)
Humans , Female , Hernia, Diaphragmatic/etiology , Barium Sulfate , Enema , Hernia, Diaphragmatic/surgerySubject(s)
Humans , Hernia, Diaphragmatic/surgery , Hernia, Diaphragmatic/complications , Hernia, Diaphragmatic/diagnosis , Hernia, Diaphragmatic/epidemiology , Hernia, Diaphragmatic/etiology , Hernia, Diaphragmatic/physiopathology , Hernia, Diaphragmatic/drug therapy , Hernia, Diaphragmatic , Hernia, Diaphragmatic/therapyABSTRACT
O sinal da dupla câmara gasosa consiste na presença de gás (usualmente ar) no interior de duas cavidades naturais vizinhas e oriundas do celoma. Pode ser visualizado numa radiografia do tórax ou abdome e encontrado em três combinaçöes distintas: a) pneumotórax e pneumoperitônio; b) pneumotórax e pneumopericárdio; c) pneumoperitônio e pneumopericárdio. Constitui uma rara manifestaçäo radiológica de hérnia de Bochdalek, deficiência congênita do pericárdio e hérnia diafragmática peritônio-pericárdia. O autor discute a sua ocorrência na ausência daquelas malformaçöes congênitas