scholarly journals The usefulness of the transesophageal Doppler in the anesthetic management of Morgagni hernia repair - A case report

2021 ◽  
Vol 25 (2) ◽  
Author(s):  
Nuno Morais De Babo ◽  
Maria Teresa Monteiro ◽  
Ana Bernardino Santos ◽  
Cludia Raquel Carreira
Keyword(s):  
Case Report ◽  
Cardiac Index ◽  
Hernia Repair ◽  
Real Time ◽  
Anesthetic Management ◽  
Esophageal Doppler ◽  
Morgagni Hernia ◽  
Left Hemithorax ◽  
Systolic Volume ◽  
Transesophageal Doppler

Morgagni hernia in adults is a rare condition and is associated with complications such as recurrent chest infections, respiratory failure and cardiac tamponade. Its correction represents an anesthetic challenge. Intraoperative esophageal Doppler provides important information in real time about the patient’s cardiac function and vascular filling, aiding in decision making by the anesthesiologist. We report a case of a 70–year–old woman, ASA Physical Status–III, and presented with chest pain, dyspnea and hypoxemia. Her chest x-ray revealed opacification of 2/3 of the left hemithorax and 1/2 of the right. Computed tomography confirmed a bilateral Morgagni hernia. The patient underwent immediate corrective surgery. Intraoperative cardiovascular function was monitored with esophageal Doppler. Compression and decompression of thoracic structures produces enormous hemodynamic and respiratory impact. After herniated contents removal it showed an increase in systolic volume and cardiac index and a correction of flow time. Transient arterial hypotension was verified, requiring fluid therapy and vasopressor support. Diaphragmatic defect was corrected and general hemodynamic stabilization was achieved. Patient was discharged asymptomatic. The esophageal Doppler was important in this case because it allowed us to measure fundamental hemodynamic variables in real time, such as cardiac index or systolic volume, and to subsequently act accordingly. Key words: Esophageal; Doppler; Morgagni hernia; Anesthesia Citation: Babo NM, Monteiro MT, Santos AB, Carreira CR. The usefulness of the transesophageal Doppler in the anesthetic management of Morgagni hernia repair - A case report. Anaesth pain intensive care 2021;25(2):206-211. DOI: 10.35975/apic.v25i2.1467  Received: 19 November 2020, Reviewed: 22 December 2020, Accepted: 12 January 2021

scholarly journals Laparoscopic Repair of Morgagni Hernia Combined with Right Hemicolectomy for Bleeding Ascending Colon Carcinoma Lodged within the Chest: A Case Report and Review of the Literature

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Oluwatobi O Onafowokan ◽  
Kiran Khosa ◽  
Hugo Bonatti
Keyword(s):  
Colon Cancer ◽  
Case Report ◽  
Hernia Repair ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Approach ◽  
Rare Condition ◽  
Right Hemicolectomy ◽  
Morgagni Hernia ◽  
The Right ◽  
Diaphragmatic Hernias

Background. Morgagni hernias are rare in adults and may be asymptomatic but, nevertheless, require surgical repair, with laparoscopy offering an excellent option. The colon dislodged into the chest through diaphragmatic hernias may be affected by various disorders, including malignancies. Case Report. A 70-year-old obese male presented with fatigue and shortness of breath. CT scan showed the right colon lodged in the chest through a Morgagni hernia. He was anaemic, and colonoscopy revealed a colon cancer. He underwent combined laparoscopic hernia repair with bioabsorbable mesh and right hemicolectomy. Recovery was uneventful, but the patient died 5 months later from chemotherapy-associated cardiac failure. Literature review revealed eight similar published cases, and including ours, there were seven Morgagni hernias, one traumatic hernia, and one Bochdalek hernia. Median age of the five men and four women was 66 (range 49-85) years. Surgical approach was thoracotomy (2), laparotomy (5), and laparoscopy (2). Conclusion. Outcome of the rare condition is determined by the course of the colon cancer. Hernia repair was successful in ours and all other published cases. A combined laparoscopic approach can be safely done.

Morgagni Hernia Repair in a Small Child Using da Vinci Robotic Instruments – A Case Report

2008 ◽  
Vol 19 (02) ◽  
pp. 110-112 ◽  
Author(s):  
M. Anderberg ◽  
C. Clementson Kockum ◽  
E. Arnbjornsson
Keyword(s):  
Case Report ◽  
Hernia Repair ◽  
Da Vinci ◽  
Small Child ◽  
Morgagni Hernia ◽  
Robotic Instruments

scholarly journals Anesthetic management of Morgagni hernia repair in an elderly woman

2015 ◽  
Vol 9 (3) ◽  
pp. 413 ◽  
Author(s):  
RajnishK Nama ◽  
BinaP Butala ◽  
VeenaR Shah ◽  
HirenR Patel
Keyword(s):  
Hernia Repair ◽  
Elderly Woman ◽  
Anesthetic Management ◽  
Morgagni Hernia

The Use of Real-Time Visual Displays of Speech in the Training of a Profoundly Deaf, Nonspeaking Child: A Case Report

1971 ◽  
Vol 36 (3) ◽  
pp. 397-409 ◽  
Author(s):  
Rachel E. Stark
Keyword(s):  
Case Report ◽  
Real Time ◽  
Speech Production ◽  
Behavior Problem ◽  
Deaf Children ◽  
Developmental Sequence ◽  
Visual Displays ◽  
Individual Instruction ◽  
Academic Record ◽  
Extract Information

Real-time amplitude contour and spectral displays were used in teaching speech production skills to a profoundly deaf, nonspeaking boy. This child had a visual attention problem, a behavior problem, and a poor academic record. In individual instruction, he was first taught to produce features of speech, for example, friction, nasal, and stop, which are present in vocalizations of 6- to 9-month-old infants, and then to combine these features in syllables and words. He made progress in speech, although sign language and finger spelling were taught at the same time. Speech production skills were retained after instruction was terminated. The results suggest that deaf children are able to extract information about the features of speech from visual displays, and that a developmental sequence should be followed as far as possible in teaching speech production skills to them.

scholarly journals Anesthetic management for cesarean delivery in a woman with congenital atlantoaxial dislocation and Chiari type I anomaly: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuyan Nie ◽  
Weimin Zhou ◽  
Shaoqiang Huang
Keyword(s):  
Case Report ◽  
Cesarean Delivery ◽  
Anesthetic Management ◽  
Neurological Complications ◽  
Atlantoaxial Dislocation ◽  
Epidural Needle ◽  
Team Approach ◽  
Anesthetic Techniques ◽  
Type I ◽  
Combined Spinal Epidural Anesthesia

Abstract Background The preferable choice of anesthesia for the patients with congenital atlantoaxial dislocation (CAAD) and type I Arnold Chiari malformations (ACM-I) has been a very confusing issue in clinical practice. We describe the successful administration of combined spinal-epidural anesthesia for a woman with CAAD and ACM-1 accompanied by syringomyelia. Case presentation Our case report presents the successful management of a challenging obstetric patient with CAAD and ACM-1 accompanied by syringomyelia. She had high risks of difficult airway and aspiration. The injection of bolus drugs through the spinal or epidural needle may worsen the previous neurological complications. The patient was well evaluated with a multidisciplinary technique before surgery and the anesthesia was provided by a skilled anesthesiologist with slow spinal injection. Conclusions An interdisciplinary team approach is needed to weigh risks and benefits for patients with CAAD and ACM-1 undergoing cesarean delivery. Therefore, an individual anesthetic plan should be made basing on the available anesthetic equipments and physicians’ clinical experience on anesthetic techniques.

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