scholarly journals BILATERAL MORGAGNI HERNIA IN INFANT, A RARE TYPE IN CONGENITAL DIAPHRAGMATIC HERNIA: A CASE SERIES

2017 ◽  
Vol 17 (2) ◽  
pp. 93-102
Author(s):  
Agung Wibawanto ◽  
Yopie Afriandi Habibie ◽  
Arman Arman
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Case Series ◽  
Left Lobe ◽  
Shortness Of Breath ◽  
Morgagni Hernia ◽  
Baby Girl ◽  
Rare Type ◽  
Abdominal Approach ◽  
First Case

Abstrak. Hernia Diafraghma Kongenital (HDK) merupakan kelainan kongenital yang jarang ditemukan pada bayi. Hernia Morgagni bilateral merupakan kasus yang sangat jarang ditemukan. Kami melaporkan kasus ini karena lokasi hernia Morgagni yang bilateral yang sangat jarang dijumpai (kanan dan kiri). Kami laporkan dua kasus dari HDK. Kasus pertama bayi perempuan usia 4 bulan dengan keluhan usus halus dan hati lobus kiri berada di dalam rongga dada yang berhubungan dengan defek anterior dari hernia diafraghma. Kasus kedua neonatus perempuan usia 22 hari datang dengan keluhan distress pernafasan, sesak nafas dan muntah. Pendekatan insisi subcotal dilakukan pada kedua pasien, dan defek dari hernia diafrahgma ditutup dengan menggunakan goretex pacth dengan hasil yang sangat baik. Pasca operasi, kedua pasien dengan kondisi sbaik, dan dipulangkan dari rumah sakit tanpa komplikasi. Berbagai macam teknik tindakan operasi telah dipaparkan, dan pendekatan dengan tindakan laparotomy telah menjadi salah satu standar teknik operasi. Tindakan ini dapat memungkinkan untuk mereduksi dan melihat isi dari hernia diafraghma tersebut, memudahkan untuk prosedur operasi dalam merepair bileteral hernia diafraghmatika. Dan sekaligus juga dapat mengkoreksi jika terdapat kelainan malrotasi dari usus halus. (JKS 2017; 2: 94-104)Kata Kunci : Bilateral Morgagni Hernia, kondisi klinis non spesifik, pendekatan abdominal.Abstract. Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly in infant. Bilateral Morgagni Hernia is an absolute rarity. We describe this case because of the absolute rarity of bilateral localization in Morgagni hernia.We present 2 case series of CDH, First case a 4-month-old baby girl was an intrathoracic bowel and left lobe liver associated with anterior diaphragmatic defects in a symptomatic. Second case was a 22 days neonates girl, presented with respiratory distress, shortness of breath and vomiting. Subcostal incision were done for both patients, defect was repair with goretex pacth with a good result. Postoperatively, both of patient enjoyed an uneventful course and was discharged home without any further events. Numerous approaches have been described and, particularly the significance of laparatomy has been emphasized as an operative technique. This allows easy reduction and inspection of contents, allows access and repair of bilateral hernias, and corrects an associated malrotation if present. (JKS 2017; 2: 94-104)Key Words : Bilateral Morgagni Hernia, Non spesific Presentations, Abdominal Approach.

scholarly journals Innovative use of mesh bolster for adult Morgagni hernia repair

2019 ◽  
Vol 2019 (7) ◽  
Author(s):  
Nabiel Azar ◽  
Robert Azar ◽  
Katie Robertson ◽  
Priya Gupta
Keyword(s):  
Chest Pain ◽  
Hernia Repair ◽  
Congenital Diaphragmatic Hernia ◽  
Shortness Of Breath ◽  
Morgagni Hernia ◽  
Adult Case ◽  
Rare Type ◽  
Lack Of Fusion ◽  
Large Size ◽  
History Of

AbstractMorgagni hernia is a rare type of congenital diaphragmatic hernia caused by lack of fusion of the pleuroperitoneal membrane anteriorly leading to a defect in the foramen of Morgagni. These are rare hernias and typically present early in life. Those that do not get repaired during infancy or adolescence often present later in life with variable symptoms including obstruction, incarceration, strangulation, pulmonary symptoms, chest pain, etc. Herein we present an adult case that was found incidentally after a screening computerized tomography (CT) chest scan was done for history of smoking. There are two unique aspects to this case: first, given the large size of her hernia, her only complaint was mild shortness of breath and second, the innovative use of mesh as a suture bolster.

Congenital Diaphragmatic Hernia: Demographics and 30-day Outcomes in Adults

2020 ◽  
pp. 000313482096006
Author(s):  
Joseph G. Brungardt ◽  
Quinn A. Nix ◽  
Kurt P. Schropp
Keyword(s):  
Postoperative Complications ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Pediatric Population ◽  
Case Series ◽  
National Database ◽  
Improvement Program ◽  
American College Of Surgeons ◽  
Postoperative Diagnosis ◽  
Acs Nsqip Database

Background Congenital diaphragmatic hernia (CDH) is a pathology most often affecting the pediatric population, although adults can also be affected. Few studies exist of adults undergoing repair of this defect. Using a national database, we sought to determine demographics and outcomes of this population. Methods An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database (2015-2018) was performed, capturing patients with postoperative diagnosis of CDH, distinct from ventral hernia. Two groups were created based upon surgical approach of open or minimally invasive (MIS) repair. Baseline demographics and outcomes were compared. Results 110 patients undergoing surgical correction of CDH were captured in the database. We found rates of return to the operating room (4.55%), postoperative respiratory failure (5.45%), and reintubation (3.64%) with no difference between groups. There was no mortality and no difference between groups in length of operation, discharge to home, or postoperative complications. Patients undergoing open repair had a longer length of stay than patients in the MIS group (6.47 ± 10.76 days vs. 3.68 ± 3.74 days, P = .0471). Mesh was used in MIS more often than the open group (47.30% vs. 5.56%, P < .0001). Discussion This study describes rates of postoperative complications in patients undergoing repair of CDH, and suggests outcomes those are equivalent between patients receiving open or MIS approaches. Further case series or retrospective studies are needed to further describe this population of patients.

scholarly journals A Triad of Congenital Diaphragmatic Hernia, Meckel’s Diverticulum, and Heterotopic Pancreas

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Parkash Mandhan ◽  
Amer Al Saied ◽  
Mansour J. Ali
Keyword(s):  
Case Report ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Chromosomal Abnormalities ◽  
Meckel’S Diverticulum ◽  
Pancreatic Tissue ◽  
Meckel's Diverticulum ◽  
Developmental Anomaly ◽  
Heterotopic Pancreatic Tissue ◽  
First Case

Congenital diaphragmatic hernia is a common developmental anomaly encountered by paediatric surgeons. It is known to be associated with extradiaphragmatic malformations, which include cardiac, renal, genital, and chromosomal abnormalities. Herein, we report a newborn born with concurrent congenital diaphragmatic hernia, Meckel’s diverticulum, and heterotopic pancreatic tissue. This is the first case report of such a triad with description of possible mechanisms of the development.

Does thoracoscopic congenital diaphragmatic hernia repair cause a significant intraoperative acidosis when compared to an open abdominal approach?

2011 ◽  
Vol 46 (3) ◽  
pp. 458-461 ◽  
Author(s):  
Julia R. Fishman ◽  
Simon C. Blackburn ◽  
Niall J. Jones ◽  
Nicholas Madden ◽  
Diane De Caluwe ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Abdominal Approach ◽  
Diaphragmatic Hernia Repair

scholarly journals Morgagni hernia: Report of two cases and brief review of anatomy and literature

2018 ◽  
Vol 4 (1) ◽  
pp. 10
Author(s):  
Emilia Krol ◽  
Michael W. McCormick ◽  
Daniel M. Chase ◽  
Dorothy A. Sparks ◽  
Gregg L. Bogen ◽  
...  
Keyword(s):  
Transverse Colon ◽  
Elderly Woman ◽  
Clinical Presentation ◽  
Case Series ◽  
The Other ◽  
Chest Discomfort ◽  
Morgagni Hernia ◽  
Hernia Sac ◽  
First Case ◽  
Diaphragmatic Hernias

Morgagni hernias are rare defects which comprise approximately three percent of congenital diaphragmatic hernias. They are often found incidentally but may present with symptoms of bowel obstruction due to viscera entering the hernia sac. Here we present a case series of two Morgagni hernias. The first case is an elderly woman who presented with strangulated transverse colon in the hernia sac, and the other is a young man who complained of vague chest discomfort. These cases exemplify the varied clinical presentation of Morgagni hernias, the importance of being cognizant of their pathology, and their treatment.

scholarly journals Neonates With Complex Cardiac Malformation and Congenital Diaphragmatic Hernia Born to SARS-CoV-2 Positive Women—A Single Center Experience

2020 ◽  
Vol 11 (6) ◽  
pp. 697-703
Author(s):  
Nimrod Goldshtrom ◽  
Diana Vargas ◽  
Angelica Vasquez ◽  
Faith Kim ◽  
Kinjal Desai ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Congenital Heart ◽  
Clinical Course ◽  
Medical Center ◽  
Horizontal Transmission ◽  
Academic Medical Center ◽  
Case Series ◽  
Adverse Outcomes ◽  
The Impact

Background: Our understanding of the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on pregnancies and perinatal outcomes is limited. The clinical course of neonates born to women who acquired coronavirus disease 2019 (COVID-19) during their pregnancy has been previously described. However, the course of neonates born with complex congenital malformations during the COVID-19 pandemic is not known. Methods: We report a case series of seven neonates with congenital heart and lung malformations born to women who tested positive for SARS-CoV-2 during their pregnancy at a single academic medical center in New York City. Results: Six infants had congenital heart disease and one was diagnosed with congenital diaphragmatic hernia. In all seven infants, the clinical course was as expected for the congenital lesion. None of the seven exhibited symptoms generally associated with COVID-19. None of the infants in our case series tested positive by nasopharyngeal test for SARS-CoV-2 at 24 hours of life and at multiple points during their hospital course. Conclusions: In this case series, maternal infection with SARS-CoV-2 during pregnancy did not result in adverse outcomes in neonates with complex heart or lung malformations. Neither vertical nor horizontal transmission of SARS-CoV-2 was noted.

scholarly journals Heart hypoplasia in an animal model of congenital diaphragmatic hernia

2001 ◽  
Vol 56 (6) ◽  
pp. 173-178 ◽  
Author(s):  
Uenis Tannuri
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Experimental Model ◽  
Diaphragmatic Hernia ◽  
Interventricular Septum ◽  
Left Lung ◽  
Therapeutic Strategies ◽  
Left Lobe ◽  
The Body ◽  
Lung Hypoplasia ◽  
The Right

PURPOSE: In previous papers, we described a new experimental model of congenital diaphragmatic hernia in rabbits, and we also reported noninvasive therapeutic strategies for prevention of the functional and structural immaturity of the lungs associated with this defect. In addition to lung hypoplasia, pulmonary hypertension, biochemical, and structural immaturity of the lungs, the hemodynamics of infants and animals with congenital diaphragmatic hernia are markedly altered. Hence, cardiac hypoplasia has been implicated as a possible cause of death in patients with congenital diaphragmatic hernia, and it is hypothesized to be a probable consequence of fetal mediastinal compression by the herniated viscera. Cardiac hypoplasia has also been reported in lamb and rat models of congenital diaphragmatic hernia. The purpose of the present experiment was to verify the occurrence of heart hypoplasia in our new model of surgically produced congenital diaphragmatic hernia in fetal rabbits. METHODS: Twelve pregnant New Zealand rabbits underwent surgery on gestational day 24 or 25 (normal full gestational time - 31 to 32 days) to create left-sided diaphragmatic hernias in 1 or 2 fetuses per each doe. On gestational day 30, all does again underwent surgery, and the delivered fetuses were weighed and divided into 2 groups: control (non-surgically treated fetuses) (n = 12) and congenital diaphragmatic hernia (n = 9). The hearts were collected, weighed, and submitted for histologic and histomorphometric studies. RESULTS: During necropsy, it was noted that in all congenital diaphragmatic hernia fetuses, the left lobe of the liver herniated throughout the surgically created defect and occupied the left side of the thorax, with the deviation of the heart to the right side, compressing the left lung; consequently, this lung was smaller than the right one. The body weights of the animals were not altered by congenital diaphragmatic hernia, but heart weights were decreased in comparison to control fetuses. The histomorphometric analysis demonstrated that congenital diaphragmatic hernia promoted a significant decrease in the ventricular wall thickness and an increase in the interventricular septum thickness. CONCLUSION: Heart hypoplasia occurs in a rabbit experimental model of congenital diaphragmatic hernia. This model may be utilized for investigations in therapeutic strategies that aim towards the prevention or the treatment of heart hypoplasia caused by congenital diaphragmatic hernia.

scholarly journals Laparoscopic Features and Repair of a Combined left Spigelian Hernia and left Morgagni Diaphragmatic Hernia

2015 ◽  
Vol 97 (2) ◽  
pp. e25-e26 ◽  
Author(s):  
SL Chamary ◽  
VL Chamary
Keyword(s):  
Early Detection ◽  
Early Diagnosis ◽  
Diaphragmatic Hernia ◽  
Spigelian Hernia ◽  
Morgagni Hernia ◽  
First Case ◽  
Detection And Diagnosis ◽  
The Right ◽  
Early Detection And Diagnosis ◽  
Timely Treatment

Both Spigelian and Morgagni hernias cause serious morbidity so early diagnosis and timely treatment are necessary. These two types of hernia are more commonly found on the right side of patients. They are rare individually in adults and even rarer in combination. So far, an association between the two hernias has only been reported on the right. We describe the first case of a Spigelian hernia and a Morgagni hernia in a 62-year-old woman, both occurring on the left side. Our accompanying video describes several laparoscopic features that will help lead to early detection and diagnosis.

CONTEMPORARY NEONATAL INTENSIVE CARE MANAGEMENT IN CONGENITAL DIAPHRAGMATIC HERNIA: DOES THIS OBVIATE THE NEED FOR FETAL THERAPY?

2009 ◽  
Vol 20 (4) ◽  
pp. 319-339 ◽  
Author(s):  
DESMOND BOHN
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Case Reports ◽  
Rescue Therapy ◽  
Intervention Strategy ◽  
Case Series ◽  
High Volume ◽  
Vasodilator Therapy ◽  
Operative Stabilization ◽  
Pulmonary Vasodilator

The management of congenital diaphragmatic hernia (CDH) in the newborn infant has changed radically since the first successful outcomes were reported 60 years ago. Then it seemed a surgical problem with a surgical solution – do an operation, remove the intestines and solid viscera from the thoracic cavity, repair the defect and allow the lung to expand. CDH in that era was regarded as the quintessential neonatal surgical emergency. The expectation was that urgent surgery would result in improvement in lung function and oxygenation. That approach persisted up to the 1980s when it was realized that the problem was far more complex and involved both an abnormal pulmonary vascular bed as well as pulmonary hypoplasia. The use of systemically delivered pulmonary vasodilator therapy, principally tolazoline, became a focus of interest in the 1980s with small case reports and case series suggesting improved survival. In the 1990s, based on studies that showed worsening thoracic compliance and gas exchange following surgical repair, deferred surgery and pre-operative stabilization became the standard of care. At the same time extracorporeal membrane oxygenation (ECMO) was increasingly used either as part of pre-operative stabilization or as a rescue therapy after repair. Other centres chose to use high frequency oscillatory ventilation (HFOV). Despite all these innovations the survival in live born infants with CDH did not improve to more than 50% in large series published from high volume centres. However, in the past 10 years there has been an appreciable improvement in survival to the extent that many centres are now reporting survival rates of greater than 80%. Probably the biggest impact on this improvement has been the recognition of the role that ventilation induced lung injury plays in mortality and the need for ECMO rescue. This has ushered in an era of a lung protective or “gentle ventilation” strategy which has been widely adopted as a standard approach. While there have been these radical changes in postnatal management attempts have been made to improve outcome with prenatal interventions, starting with prenatal repair, which was abandoned because of preterm labour. More recently there has been increasing experience in the use of balloon occlusion of the trachea as a prenatal intervention strategy with patients being selected based on prenatal predictors of poor outcome. This approach can only be justified if those predictors can be validated and the outcomes (death or serious long term morbidity) can be shown to be better than those currently achievable, namely 80% survival in high volume CDH centres rather than the 50–60% survival frequently quoted in historical papers.

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