ABSTRACT
BACKGROUND: Diaphragmatic hernia is migration of abdominal viscera into the thoracic cavity through a defect in the diaphragm. In children, it is mostly congenital; traumatic diaphragmatic hernia being less common. This study aimed to review our experience with traumatic diaphragmatic rupture (TDR) and to identify the clinical findings and diagnostic modality that may help in early diagnosis and prompt therapy. METHODS: The study involved 11 children (1-18 years old) with TDR who were hospitalised between 1993 and 2005. In addition to clinical examination, a plain X-ray of the chest and abdomen, an ultrasound, barium studies, and a computerised tomography (CT) scan were used to evaluate the patients. RESULTS: All of the diaphragmatic ruptures occurred on the left side, with 10 occurring in the posterolateral part and 1 near the oesophageal hiatus. Two of our patients presented 7 and 10 days after the injury, and 1 patient presented 1 year after the trauma. CONCLUSION: TDR should remain a diagnostic possibility in children. These patients are best assessed using a CT scan. New research on stem cells and tissue-engineered bioprosthetics may pave the path for better future therapies in these cases.
ABSTRACT
Presentation with simultaneous bilateral pneumothorax is uncommon and usually in the context of secondary spontaneous pneumothorax. The association of pneumothorax and silicosis is infrequent and most cases are unilateral. Bilateral pneumothorax in silicosis is very rare with just a few reports in medical literature.
ABSTRACT
We report three cases of ectopic thoracic (or superior ectopic) kidney; one in a neonate and two in 6-month-old children, associated with congenital diaphragmatic hernia. In all cases the diagnosis was made during surgery and confirmed by intravenous pyelography, sonography and magnetic resonance imaging in the postoperative period. Because of the rarity of this condition we report these cases together with a wide review of the published reports.
Subject(s)
Choristoma/diagnosis , Hernias, Diaphragmatic, Congenital , Kidney , Thoracic Diseases/diagnosis , Choristoma/diagnostic imaging , Choristoma/surgery , Female , Hernia, Diaphragmatic/diagnostic imaging , Hernia, Diaphragmatic/surgery , Humans , Infant , Infant, Newborn , Male , Pregnancy , Radiography , Thoracic Diseases/diagnostic imaging , Thoracic Diseases/surgeryABSTRACT
We report two sets of parasitic twins attached in the thoracic region. Exomphalos major in the autosite was present in both cases. While in case 1, the autosite could be salvaged after easier dissection, in case 2, the autosite could not be salvaged due to the presence of the life-threatening anomalies. The presence of a right-angled communication between the gastrointestinal tracts of the autosite and the independent tactile responses of the parasite from that in the autosite supports the 'fusion theory' to explain the fusion of the embryos that could have led to this defect. The presence of the ano-rectal malformation and common bile duct dilatation exclusively in the parasite appears to be the result of the abnormalities in the endodermal-mesodermal interactions, probably due to the relative positioning of the parasite with respect to the autosite.
