scholarly journals Bochdalek Hernia

2018 ◽  
Vol 2 (2) ◽  
pp. 40
Author(s):  
Yuliaji Narendra Putra ◽  
Tubagus Odih Rhomdani Wahid ◽  
Guntur Surya Alam ◽  
Rohadi Rohadi

Background: Bochdalek hernia is a congenital defect on posterolateral diaphragm with an abnormal connection between the thoracic cavity and the abdominal cavity. This disease causes protrusion of abdominal organs into the thoracic cavity. Case: an 8-day-old baby girl admitted to hospital with shortness of breath 24 hours after delivered. The baby was born spontaneously assisted by midwife. Upon born, the baby was crying strongly and meconium came out 2 hours after birth. On physical examination, the abdomen was inspected flat. Darm contour and darm steifung was observed, and peristaltic sound was heard on left lung. Radiological examination demonstrated a diaphragmatic hernia with ileus obstruction. The patient underwent laparatomy and stomach, ileum, transverse colon, and spleen, was found on foramen Bochdalek. Post-surgery chest X Ray showed favourable result. Ten days after treatment, the patient was discharged in a good condition with no respiratory or digestive problems. After 1 months the patient’s condition remained good and there were no respiratory or digestive complaints. Conclusion: In a rare case like Bochadalek hernia, laparotomy performed as a promising attempt to return the anatomic position of organ.

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sho Nambara ◽  
Yoshihisa Sakaguchi ◽  
Fumihiro Shoji ◽  
Yasuo Tsuda ◽  
Kensuke Kudou ◽  
...  

Abstract Background Bochdalek hernia is a rare disease in adults. Diaphragmatic hernia in adults has been repaired using minimally invasive surgery through laparoscopy or thoracoscopy. However, the literature regarding the combined use of laparoscopy and thoracoscopy for the repair of Bochdalek hernia is limited. Case presentation A 26-year-old man diagnosed with Bochdalek hernia was managed through combined abdominal and thoracic endoscopic surgery. On laparoscopy, the omentum prolapsed into the left thoracic cavity through the posterolateral area of the left diaphragm. On thoracoscopy, no adhesions of the omentum were seen in the thoracic cavity. The omentum was drawn back to the abdominal cavity, and a 4 × 3-cm hernial orifice was identified. The hernia orifice was repaired through simple closure with sutures laparoscopically. The patient’s postoperative course was uneventful with no recurrences within the first year post-surgery. Conclusion Combined laparoscopic and thoracoscopic surgery is a safe and effective method for Bochdalek hernial repair in adults.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Takehiko Manabe ◽  
Kenji Ono ◽  
Soichi Oka ◽  
Yuichiro Kawamura ◽  
Toshihiro Osaki

Abstract Background Pleuroperitoneal communication (PPC) is rarely observed, accounting for 1.6% of all patients who undergo continuous ambulatory peritoneal dialysis (CAPD). Although there have been several reports concerning the management of this condition, we have encountered several cases in which control failed. We herein report a valuable case of PPC in which laparoscopic pneumoperitoneum with video-assisted thoracic surgery (VATS) was useful for supporting the diagnosis and treatment. Case presentation The patient was a 58-year-old woman with chronic renal failure due to chronic renal inflammation who was referred to a nephrologist in our hospital to undergo an operation for the induction of CAPD. Post-operatively, she had respiratory failure, and chest X-ray and computed tomography (CT) showed right-sided hydrothorax that decreased when the injection of peritoneal dialysate was interrupted. Therefore, PPC was suspected, and she was referred to our department for surgical repair. We planned surgical treatment via video-assisted thoracic surgery. During the surgery, we failed to detect any lesions with thoracoscopy alone; we therefore added a laparoscopic port at her right-sided abdomen near the navel and infused CO2 gas into the abdominal cavity. On thoracoscopy, bubbles were observed emanating from a small pore at the central tendon of the diaphragm, which was considered to be the lesion responsible for the PPC. We closed it by suturing directly. Conclusions VATS with laparoscopic pneumoperitoneum should be considered as an effective method for inspecting tiny pores of the diaphragm, especially when the lesions responsible for PPC are difficult to detect.


2011 ◽  
Vol 2011 ◽  
pp. 1-6
Author(s):  
Aristida Georgescu ◽  
Crinu Nuta ◽  
Simona Bondari

Unilateral primary pulmonary hypoplasia is rare in adulthood (UPHA); it is characterized by a decreased number of bronchial segmentation and decreased/absent alveolar air space. Classical chest X-ray may be confusing, and the biological tests are unspecific. We present a case of UPHA in a 60-year-old female, smoker, with 3 term normal deliveries, who presented with late recurrent pneumonias and bronchiectasis-type symptomathology, arterial hypertension, and obesity. Chest X-rays revealed opacity in the left lower pulmonary zone, an apparent hypoaerated upper left lobe and left deviation of the mediastinum. Preoperatory multidetector computer tomography (MDCT) presented a small retrocardiac left lung with 5-6 bronchial segmentation range and cystic appearance. After pneumonectomy the gross specimen showed a small lung with multiple bronchiectasis and small cysts, lined by hyperplasic epithelium, surrounded by stromal fibrosclerosis. We concluded that this UPHA occurred in the 4–7 embryonic weeks, and the 3D MDCT reconstructions offered the best noninvasive diagnosis.


1992 ◽  
Vol 106 (8) ◽  
pp. 751-752 ◽  
Author(s):  
Hassan H. Ramadan ◽  
Nicolas Bu-Saba ◽  
Anis Baraka ◽  
Salman Mroueh

AbstractForeign body aspiration is a very common problem in children and toddlers and still a serious and sometimes fatal condition. We are reporting on a 2-year-old white asthmatic male who choked on a chick pea and presented with subcutaneous emphysema, and on chest X-ray with an isolated pneumomediastinum but not pneumothorax. On review of the literature an isolated pneumomediastinum without pneumothorax was rarely reported. This presented a challenge in management mainly because of the technique that we had to use in order to undergo bronchoscopy and removal of the foreign body. Apnoeic diffusion oxygenation was used initially while the foreign body was removed piecemeal, and afterwards intermittent positive pressure ventilation was used. The child did very well, and his subcutaneous emphysema and pneumomediastinum remarkably improved immediately post surgery.


2021 ◽  
Vol 100 (1) ◽  
pp. 30-35
Author(s):  
N.S. Vorotyntseva ◽  
◽  
V.V. Orlova ◽  
A.N. Motina ◽  
A.D. Novikova ◽  
...  

Objective of the research: to study the features of the radiological picture of the brain and internal organs of newborns with severe perinatal asphyxia, who underwent general therapeutic hypothermia (GTH). Materials and methods: the study included 116 newborns with severe perinatal asphyxia. GTH was performed in 72 patients (group 1), 44 children did not receive hypothermia in the 2 (control) group. In the first 6 hours of life, children of groups 1 and 2 underwent ultrasound of the brain and abdominal organs and chest x-ray. The complex ultrasound scan was repeated at 3–5, 7–10, 14–16 and 21–28 days. Repeated chest x-ray was carried out strictly according to the indications. Results: GTH reduced the incidence of organic brain lesions by 18% in children with severe perinatal asphyxia (p0,05). The study revealed a number of undesirable consequences associated with GTH. Transient effusion into the abdominal and thoracic cavities was diagnosed by ultrasound in 8 (11%) patients after hypothermia, while there were no such changes in children in the control group (p<0,05). X-ray of the chest in newborns who received GTH during the first 14 days revealed edematous-hemorrhagic changes in the lungs more often than in patients of the control group – 55 (76%) and 24 (55%), respectively (p<0,05). Conclusions: GTH effectively prevented the development of severe post-hypoxic changes in the brain. The negative effect of hypothermia on microcirculation was manifested by the development of effusion into the serous cavities and edematous-hemorrhagic syndrome.


2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
Valeria Fiaschetti ◽  
Luca Velari ◽  
Eleonora Gaspari ◽  
Roberta Mastrangeli ◽  
Giovanni Simonetti

Introduction. Bochdalek hernia is a congenital posterior lateral diaphragmatic defect that allows abdominal viscera to herniate into the thorax. Intrathoracic kidney is a very rare finding representing less than 5% of all renal ectopias with the least frequency of all renal ectopias.Case Presentation. We report a case of a 62-year-old man who had a left thoracic kidney associated with left Bochdalek hernia. Abdominal X-ray and chest X-ray revealed dilated loops of the colon above left hemidiaphragm. Abdominal ultrasound (US) showed the right kidney with many fluid and esophytic cysts; left kidney was unfeasible to study because of the impossibility to find it. Computed Tomography (CT) basal scan demonstrated a left-sided Bochdalek hernia with dilatated colon loops and the left kidney within the pleural space. Magnetic Resonance (MR) confirmed a defect in left hemidiaphragm with herniation of left kidney, omento, spleen and colon flexure, and intrarotation with posterior hilum on sagittal plane.Conclusion. The association of a Bochdalek hernia and an intrathoracic renal ectopia is very rare, that pose many diagnostic and management dilemmas for clinicians. Our patient has been visualized by CT and MR imaging. A high index of suspicion can result in early diagnosis and prompt intervention with reduced morbidity and mortality.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kosaku Komiya ◽  
Ryosuke Hamanaka ◽  
Hisayuki Shuto ◽  
Hiroki Yoshikawa ◽  
Atsushi Yokoyama ◽  
...  

Abstract Background Re-expansion pulmonary edema is an uncommon complication following drainage of a pneumothorax or pleural effusion. While pneumothorax is noted to complicate COVID-19 patients, no case of COVID-19 developing re-expansion pulmonary edema has been reported. Case representation A man in his early 40 s without a smoking history and underlying pulmonary diseases suddenly complained of left chest pain with dyspnea 1 day after being diagnosed with COVID-19. Chest X-ray revealed pneumothorax in the left lung field, and a chest tube was inserted into the intrathoracic space without negative pressure 9 h after the onset of chest pain, resulting in the disappearance of respiratory symptoms; however, 2 h thereafter, dyspnea recurred with lower oxygenation status. Chest X-ray revealed improvement of collapse but extensive infiltration in the expanded lung. Therefore, the patient was diagnosed with re-expansion pulmonary edema, and his dyspnea and oxygenation status gradually improved without any intervention, such as steroid administration. Abnormal lung images also gradually improved within several days. Conclusions This case highlights the rare presentation of re-expansion pulmonary edema following pneumothorax drainage in a patient with COVID-19, which recovered without requiring treatment for viral pneumonia. Differentiating re-expansion pulmonary edema from viral pneumonia is crucial to prevent unnecessary medication for COVID-19 pneumonia and pneumothorax.


2017 ◽  
Vol 4 (10) ◽  
pp. 3548
Author(s):  
Tushar Goel ◽  
Sameer Bhate

Impalement thoracic injuries are rare of great importance due to severity and high chances of mortality. It is essential to prevent possible vascular injury by the object avoiding major haemorrhage. This study’s primary objective is to discuss 22-year-old male patient admitted in emergency with impaling thoracic trauma by metallic sharp object post battery blast at home. X-ray reveals linear foreign body: penetrating thorax and lung. CT Chest was done and assessment was made for further management with cardiothoracic department. Patient details were collected by patient’s IPD file. Complete detailed history, patient vitals, hemogram, ABO, ABG, CXR along with USG chest and abdomen and CECT chest was done. Post op daily chest X-ray and hemogram along with chest physiotherapy and spirometry was done. Treatment diagnosis was impaled linear foreign body penetrating thorax and lung, patient was shifted to OT, under GA sternotomy was performed. Foreign object passing just lateral to subclavian penetrating upper pole of lung was identified and under specific vision pulled out carefully through entry wound keeping in mind vascular trauma. Necrosed lung part was stapled and wedge resected, on POD 8 patient was discharged with satisfactory condition. Impalement thoracic traumas are rare and have high mortality. Selection of line of treatment is necessary. Indication of surgery under high risk is performed for further trauma. In our case sternotomy was planned and under specific vision impaled object which was passing just by subclavian penetrating through lung was removed safely and patient went home in good condition.


2015 ◽  
Vol 77 (2) ◽  
Author(s):  
S. Sozzo ◽  
P. Carratù ◽  
M.F. Damiani ◽  
V.A. Falcone ◽  
A. Palumbo ◽  
...  

A 57-year-old woman underwent an enucleoresection of her right kidney angiomyolipoma. Two weeks later she was admitted to our hospital because of dyspnea at rest with orthopnea. The chest x-ray showed the elevation of both hemidiaphragms and the measurement of the sniff transdiaphragmatic pressure confirmed the diagnosis of bilateral diaphragmatic paralysis. A diaphragm paralysis can be ascribed to several causes, i.e. trauma, compressive events, inflammations, neuropathies, or it can be idiopathic. In this case, it was very likely that the patient suffered from post-surgery neuralgic amyotrophy. To our knowledge, there are only a few reported cases of neuralgic amyotrophy, also known as Parsonage- Turner Syndrome, which affects only the phrenic nerve as a consequence of a surgery in an anatomically distant site.


2012 ◽  
Vol 1 (1) ◽  
pp. 33-36
Author(s):  
R Thapa ◽  
M Lakhey ◽  
U Shrestha

Sclerosing haemangioma is a rare neoplasm of the lung which behaves in a clinically benign fashion. Herein, a case of sclerosing haemangioma of the lung in a 52 years old woman is reported. She presented with symptoms of cough and chest pain. Chest X-ray and CT scan showed a well-defined lesion in lower lobe of left lung. Bronchoscopic biopsy findings were suggestive of a carcinoid tumor. Later the tumor was removed by lobectomy. The distinctive constellation of histologic findings revealed it to be a sclerosing haemangioma. DOI: http://dx.doi.org/10.3126/jkmc.v1i1.7254 Journal of Kathmandu Medical College, Vol. 1, No. 1, Issue 1, Jul.-Sep., 2012 pp.33-36


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