scholarly journals Delayed Presentation of Traumatic Right-Sided Diaphragmatic Hernia after Abdominoplasty

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Caroline C. Jadlowiec ◽  
Lois U. Sakorafas
Keyword(s):  
Diaphragmatic Hernia ◽  
Normal Pressure ◽  
Positive Pressure ◽  
Delayed Presentation ◽  
Pressure Gradients ◽  
Abrupt Changes ◽  
Thoracic And Abdominal ◽  
Pressure Changes ◽  
Surgical Manipulation ◽  
Diaphragmatic Hernias

Traumatic diaphragmatic hernias are rare and challenging to diagnose. Following trauma, diagnosis may occur immediately or in a delayed fashion. It is believed that left traumatic diaphragmatic hernias are more common as a result of the protective right-sided anatomic lie of the liver. If unrecognized, traumatic diaphragmatic injuries are subject to enlarge over time as a result of the normal pressure changes observed between the thoracic and abdominal cavities. Additionally, abrupt changes to the pressure gradients, such as those which occur with positive pressure ventilation or surgical manipulation of the abdominal wall, can act as a nidus for making an asymptomatic hernia symptomatic. We report our experience with a delayed traumatic right-sided diaphragmatic hernia presenting with large bowel incarceration two months after abdominoplasty. In our review of the literature, we were unable to find any reports of delayed presentation of a traumatic right-sided diaphragmatic hernia occurring acutely following abdominoplasty.

scholarly journals Obstructed descending colon mass pretended with Bockdalek hernia: a case report

2021 ◽  
Author(s):  
mohammad eslamian ◽  
Mohsen kolahdouzan
Keyword(s):  
Diaphragmatic Hernia ◽  
Abdominal Pressure ◽  
Right Colon ◽  
Abdominal Ct ◽  
Midline Laparotomy ◽  
Abdominal Ct Scan ◽  
Descending Colon ◽  
The Right ◽  
Thoracic And Abdominal ◽  
Diaphragmatic Hernias

Abstract Introduction: Adult Bochdalek hernia is one of the right-sided diaphragmatic hernias that less than 30 cases reported until now.Case: I herein report a 64-year-old female patient who had dyspnea, abdominal pain, and nausea. Primary imaging (thoracic and abdominal CT scan) showed a right-sided diaphragmatic hernia that was contained the liver and right colon. The patient underwent right posterior thoracotomy at first, so the 5*5 cm diaphragmatic defect was repaired. Due to peritonitis that happened after two days, a midline laparotomy was performed. Finally, it was cleared that the main problem was the obstructed and perforated descending colon mass that was presented with Bockdalek hernia. Unfortunately, she died.Conclusion It is important to determine the reason for the presentation of the symptomatic diaphragmatic hernia in adult patients. It should be considered that an increase of intra-abdominal pressure like the presence of obstructed colon mass can cause it.

Iatrogenic Incarcerated Diaphragmatic Hernia after Nissen Fundoplication

2018 ◽  
Vol 84 (7) ◽  
pp. 1195-1196 ◽  
Author(s):  
Kathryn Sommese ◽  
Katherine Kelley ◽  
Bethany Tan ◽  
Mark Fontana ◽  
Jared Brooks
Keyword(s):  
Diaphragmatic Hernia ◽  
Nissen Fundoplication ◽  
Wedge Resection ◽  
Diaphragmatic Defect ◽  
Distal Stomach ◽  
Delay In Diagnosis ◽  
Greater Curvature ◽  
One Year ◽  
Thoracic And Abdominal ◽  
Diaphragmatic Hernias

Postoperative iatrogenic diaphragmatic hernias have been reported sparingly after several thoracic and abdominal surgeries. Although rare, a delay in diagnosis can lead to life-threatening cases of strangulation or perforation, as well as cardiovascular and respiratory insufficiency. This is a case of a 78-year-old female who developed acute obstructive symptoms secondary to herniation of the distal stomach through a defect in the central tendon of the diaphragm. The diaphragmatic defect was presumed to be iatrogenically acquired after Nissen fundoplication one year prior. Other etiologies were not as likely considering that she had never had any trauma to her chest or abdomen and had no history suggestive of a congenital nature for the diaphragmatic hernia. The hernia was successfully decompressed laparoscopically with the stomach having ischemic changes along the greater curvature, necessitating gastric wedge resection. The diaphragmatic defect, which was lengthened to reduce the edematous incarcerated stomach, was repaired primarily. The patient had an uneventful postoperative course. This case highlights the potential complication of incarcerated diaphragmatic hernia after Nissen fundoplication. Late diagnosis of iatrogenic diaphragmatic hernias is frequent because of nonspecific symptoms and surgery is indicated at the time of diagnosis.

Meetings of the Scientific Club of the Rybinsk Medical Section

1927 ◽  
Vol 23 (4) ◽  
pp. 480-480
Keyword(s):  
Diaphragmatic Hernia ◽  
Hernia Surgery ◽  
Abdominal Organs ◽  
Medical Section ◽  
Thoracic And Abdominal ◽  
Diaphragmatic Hernias

Dr. Bronnikov A.N.: On the technique of diaphragmatic hernia surgery. The reporter pointed out that there is no unanimity among surgeons as to how to operate on diaphragmatic hernias - both thoracic and abdominal and mixed ways are used here, and Professor Sokolov is also an advocate of the transpleural method, but the reporter disagrees with him due to the impossibility to inspect abdominal organs which may be injured by this method.

Pressure Gradients Affecting the Labyrinth during Hypobaric Pressure

1997 ◽  
Vol 106 (6) ◽  
pp. 495-502 ◽  
Author(s):  
Konrád S. Konrádsson ◽  
Björn I. R. Carlborg ◽  
Joseph C. Farmer
Keyword(s):  
Cerebrospinal Fluid ◽  
Eustachian Tube ◽  
Ambient Pressure ◽  
Pressure Gradients ◽  
Cochlear Aqueduct ◽  
Fluid Compartment ◽  
Large Pressure ◽  
Fluid Compartments ◽  
Pressure Changes ◽  
Considerable Pressure

Hypobaric effects on the perilymph pressure were investigated in 18 cats. The perilymph, tympanic cavity, cerebrospinal fluid, and systemic and ambient pressure changes were continuously recorded relative to the atmospheric pressure. The pressure equilibration of the eustachian tube and the cochlear aqueduct was studied, as well as the effects of blocking these channels. During ascent, the physiologic opening of the eustachian tube reduced the pressure gradients across the tympanic membrane. The patent cochlear aqueduct equilibrated perilymph pressure to cerebrospinal fluid compartment levels with a considerable pressure gradient across the oval and round windows. With the aqueduct blocked, the pressure decrease within the labyrinth and tympanic cavities was limited, resulting in large pressure gradients toward the chamber and the cerebrospinal fluid compartments, respectively. We conclude that closed cavities with limited pressure release capacities are the cause of the pressure gradients. The strain exerted by these pressure gradients is potentially harmful to the ear.

scholarly journals Faecopneumothorax due to missing diaphragmatic hernia: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Resul Nusretoğlu ◽  
Yunus Dönder
Keyword(s):  
Computed Tomography ◽  
Diaphragmatic Hernia ◽  
Colon Resection ◽  
Emergency Laparotomy ◽  
Hernia Sac ◽  
Case Presentation ◽  
Abdominal Tenderness ◽  
History Of ◽  
Diaphragmatic Hernias ◽  
Tomography Scan

Abstract Background Diaphragmatic hernias may occur as either congenital or acquired. The most important cause of acquired diaphragmatic hernias is trauma, and the trauma can be due to blunt or penetrating injury. Diaphragmatic hernia may rarely be seen after thoracoabdominal trauma. Case presentation A 54-year-old Turkish male patient admitted to the emergency department with abdominal pain and dyspnea ongoing for 2 days. He had general abdominal tenderness in all quadrants. He had a history of a stabbing incident in his left subcostal region 3 months ago without any pathological findings in thoracoabdominal computed tomography scan. New thoracoabdominal computed tomography showed a diaphragmatic hernia and fluid in the hernia sac. Due to respiratory distress and general abdominal tenderness, the decision to perform an emergency laparotomy was made. There was a 6 cm defect in the diaphragm. There were also necrotic fluids and stool in the hernia sac in the thorax colon resection, and an anastomosis was performed. The defect in the diaphragm was sutured. The oral regimen was started, and when it was tolerated, the regimen was gradually increased. The patient was discharged on the postoperative 11th day. Conclusions Acquired diaphragmatic hernia may be asymptomatic or may present with complications leading to sepsis. In this report, acquired diaphragmatic hernia and associated colonic perforation of a patient with a history of stab wounds was presented.

Pressure Changes Induced by Whole Body Acceleration Shocks

1991 ◽  
Vol 113 (1) ◽  
pp. 27-29 ◽  
Author(s):  
E. Belardinelli ◽  
M. Ursino ◽  
G. Fabbri ◽  
A. Cevese ◽  
F. Schena
Keyword(s):  
Mathematical Model ◽  
Carotid Artery ◽  
Normal Pressure ◽  
Compressed Air ◽  
Whole Body ◽  
Body Acceleration ◽  
Vascular Bed ◽  
Pressure Changes ◽  
The Mathematical Model

In the present paper pressure changes induced by sudden body acceleration are studied “in vivo” on the dog and compared to the results obtainable with a recently developed mathematical model. A dog was fixed to a movable table, which was accelerated by a compressed air piston for less than 1 s. Acceleration was varied by changing the air pressure in the piston. Pressure was measured during the experiment at different points along the vascular bed. However, only data obtained in the carotid artery and abdominal aorta are presented here. The results demonstrated that impulse body accelerations cause significant pressure peaks in the vessel examined (about + 25 mmHg in the carotid artery with body acceleration of g/2). Moreover, pressure changes are rapidly damped, with a time constant of about 0.1s. From the present results it may be concluded that, according to the prediction of the mathematical model, body accelerations such as those occurring in normal life can induce pressure changes well beyond the normal pressure value.

scholarly journals Direct Measurement of Stress at the Base of a Glacier

1979 ◽  
Vol 22 (86) ◽  
pp. 3-24 ◽  
Author(s):  
G. S. Boulton ◽  
E. M. Morris ◽  
A. A. Armstrong ◽  
A. Thomas
Keyword(s):  
Shear Stress ◽  
Volume Concentration ◽  
Normal Pressure ◽  
Spatial Average ◽  
Short Term ◽  
Overburden Pressure ◽  
Basal Ice ◽  
Debris Particles ◽  
Or Groups ◽  
Pressure Changes

AbstractContact stress transducers were placed in subglacial bedrock and used to monitor continuously shear stress and normal pressure changes at the contact with the overriding glacier sole 100 m beneath the surface of the Glacier d’Argentière during periods in summer 1973 and spring 1975. The measured fluctuations in normal pressure and shear stress do not appear to be related to changes in sliding velocity. Analysis of the data reveals short-term fluctuations in normal pressure and shear stress which appear to be related to the passage of individual large debris particles or groups of particles over the transducer. The shear stress appears to be a function of the volume concentration of debris in the ice. The volume concentration at any point appears to be partially dependent on a “streaming” process by which basal debris-rich ice tends to flow around the lateral flanks of hummocks on the glacier bed. Where sub-glacial cavities occur, this streaming effect appears to be dependent on the extent of cavitation and thus on ice overburden pressure and velocity. It is suggested that this process can account for an apparent lag between changes in normal pressure and shear stress.The maximum ratio between shear and normal stress averaged over a period of 10 min was 0.44. This is equivalent to a spatial average over 0.3 cm. Debris concentrations in basal ice of up to 43% by volume occurred. It is suggested that concentrations of this order are common at the base of temperate glaciers and thus that a significant part of the drag at the base of a glacier may be contributed by frictional interactions between the basal-debris load and the bed.

scholarly journals A rare diaphragmatic hernia with a delayed presentation of intestinal symptoms following spleno-distal pancreatectomy: a case report

2017 ◽  
Vol 2017 (7) ◽  
Author(s):  
Giancarlo Pansini ◽  
Giovanni Pascale ◽  
Ilaria Pigato ◽  
Enzo Malvicini ◽  
Dario Andreotti ◽  
...  
Keyword(s):  
Case Report ◽  
Distal Pancreatectomy ◽  
Diaphragmatic Hernia ◽  
Delayed Presentation ◽  
Intestinal Symptoms

Anatomical Effects of Sudden Middle Ear Pressure Changes

1979 ◽  
Vol 88 (3) ◽  
pp. 368-376 ◽  
Author(s):  
A. Axelsson ◽  
J. Miller ◽  
M. Silverman
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Round Window ◽  
Applied Pressure ◽  
Positive Pressure ◽  
Air Bubbles ◽  
Scala Tympani ◽  
Middle Ear Pressure ◽  
Contralateral Ear ◽  
Pressure Changes

Acute middle ear (ME) and inner ear changes following brief unilateral phasic ME pressure changes (up to ± 6000/mm H2O) were studied in the guinea pig. Middle ear findings included perforation of the tympanic membrane, serous and serosanguinous exudate and hemorrhage of tympanic membrane and periosteal vessels. Changes were related to magnitude of applied pressure. Perforation and hemorrhage were more commonly seen with negative rather than positive pressure. Air bubbles behind the round window were seen with positive pressures. Occasional distortion, but never perforation of the round window, was noted. Hemorrhage of the scala tympani was observed with both positive and negative pressures; scala vestibuli hemorrhage was found with negative ME pressure. In some instances pressure direction and magnitude related changes were seen in the contralateral ear.

Study of Toynbee Phenomenon by Combined Intranasopharyngeal and Tympanometric Measurements

1988 ◽  
Vol 97 (2) ◽  
pp. 199-206 ◽  
Author(s):  
Yehuda Finkelstein ◽  
Yuval Zohar ◽  
Yoav P. Talmi ◽  
Nelu Laurian
Keyword(s):  
Middle Ear ◽  
Negative Pressure ◽  
Pressure Change ◽  
Positive Pressure ◽  
New Information ◽  
Pressure Changes ◽  
Rapid Pressure

The Toynbee maneuver, swallowing when the nose is obstructed, leads in most cases to pressure changes in one or both middle ears, resulting in a sensation of fullness. Since first described, many varying and contradictory comments have been reported in the literature concerning the type and amount of pressure changes both in the nasopharynx and in the middle ear. In our study, the pressure changes were determined by catheters placed into the nasopharynx and repeated tympanometric measurements. New information concerning the rapid pressure variations in the nasopharynx and middle ear during deglutition with an obstructed nose was obtained. Typical individual nasopharyngeal pressure change patterns were recorded, ranging from a maximal positive pressure of + 450 to a negative pressure as low as −320 mm H2O.

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