scholarly journals Late-Presenting Left-Sided Morgagni Congenital Diaphragmatic Hernia in a 9-Year-Old Male

2011 ◽  
Vol 2011 ◽  
pp. 1-4
Author(s):  
Jennifer M. Kim ◽  
Marisa Couluris ◽  
Bruce M. Schnapf
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Gastrointestinal Symptoms ◽  
Lower Lobe ◽  
Abdominal Radiograph ◽  
Rare Occurrence ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
Diaphragmatic Hernias ◽  
Vague Abdominal Pain

Congenital diaphragmatic hernias are common, primarily occurring through the foramen of Bochdalek. However, in contrast, defects through the foramen of Morgagni are much more rare. When late presentations occur, patients may be asymptomatic or may be critically ill with respiratory and gastrointestinal symptoms. In this paper, we present a 9-year-old male who presented with recurrent, vague abdominal pain, and a previously normal abdominal CT scan. Initial investigation via an abdominal radiograph demonstrated an unexpected left lower lobe abnormality. Further evaluation and management revealed this abnormality to be an unusual left-sided congenital diaphragmatic hernia that appeared through the retrosternal foramen of Morgagni, a rare occurrence.

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.

Extramedullary haematopoiesis presenting as a periportal mass

2020 ◽  
Vol 13 (7) ◽  
pp. e235064
Author(s):  
Faranak Rafiee ◽  
Sara Haseli ◽  
Seyed Hamed Jafari ◽  
Pooya Iranpour
Keyword(s):  
Bone Marrow ◽  
Abdominal Pain ◽  
Histopathological Examination ◽  
Final Diagnosis ◽  
Extramedullary Haematopoiesis ◽  
Abdominal Ct ◽  
Rare Presentation ◽  
Abdominal Ct Scan ◽  
History Of ◽  
Vague Abdominal Pain

Extramedullary haematopoiesis (EMH) is defined as haematopoiesis occurring in organs outside the bone marrow. The liver is one of the rare sites of EMH, and to the best of our knowledge, a few cases of adult EMH of the liver have been reported in the last 20 years. Here, we reported the case of a 68-year-old man with a known history of myelofibrosis presented with vague abdominal pain. An abdominal CT scan showed a hypoattenuating periportal mass encasing the portal vein. The final diagnosis of EMH was made through the histopathological examination. This is a rare presentation of EMH, which may be easily mistaken for other pathologies such as metastases. Familiarity with this type of presentation aids in correctly diagnosing it in an appropriate clinical setting.

scholarly journals Laparoscopic approach for diaphragmatic hernia repair in adult: our experience of four cases

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
Abhijeet Kumar ◽  
Ratish Karn ◽  
Bhawani Khanal ◽  
Suresh Prasad Sah ◽  
Rakesh Gupta
Keyword(s):  
Diaphragmatic Hernia ◽  
Clinical Presentation ◽  
Clinical Investigation ◽  
Gastrointestinal Symptoms ◽  
Laparoscopic Approach ◽  
X Ray ◽  
Patch Closure ◽  
Thoracic Approach ◽  
Diaphragmatic Hernias ◽  
Tomography Scan

Abstract Diaphragmatic hernia can be congenital or acquired. Usual clinical presentation may range from asymptomatic cases to serious respiratory/gastrointestinal symptoms and occasionally atypical presentation as lumbar hernia also. The diagnosis of diaphragmatic hernia is based on clinical investigation and is confirmed by plain X-ray film and computed tomography scan. Various treatment approaches, open, laparoscopic and combination, are available for this condition. However, laparoscopic approach has recently gained in popularity. Surgical repair typically involves primary or patch closure of the diaphragm through an open or endoscopic abdominal or thoracic approach. This paper reflects our experience of repair of diaphragmatic hernias to evaluate its safety, efficacy and outcomes.

scholarly journals A DELAYED PRESENTATION OF RIGHT SIDED CONGENITAL DIAPHRAGMATIC HERNIA WITH RIGHT LOWER LOBE HYPOPLASIA

2015 ◽  
Vol 4 (36) ◽  
pp. 6327-6331
Author(s):  
Allena Premkumar ◽  
Namballa Usha Rani ◽  
Yellapu Gayatri ◽  
Gorantla Sambasiva Rao ◽  
Silla Monisha
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Lower Lobe ◽  
Delayed Presentation

scholarly journals Congenital Diaphragmatic Hernia: Review of Current Concept in Surgical Management

ISRN Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Emeka B. Kesieme ◽  
Chinenye N. Kesieme
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Surgical Management ◽  
Diaphragmatic Hernia ◽  
Minimal Invasive Surgery ◽  
Pulmonary Hypoplasia ◽  
Open Repair ◽  
Minimal Invasive ◽  
Fetal Intervention ◽  
Prosthetic Devices ◽  
Diaphragmatic Hernias

Congenital diaphragmatic hernias (CDHs) occur mainly in two locations: the foramen of Morgagni and the more common type involving the foramen of Bochdalek. Hiatal hernia and paraesophageal hernia have also been described as other forms of CDH. Pulmonary hypertension and pulmonary hypoplasia have been recognized as the two most important factors in the pathophysiology of congenital diaphragmatic hernia. Advances in surgical management include delayed surgical approach that enables preoperative stabilization, introduction of fetal intervention due to improved prenatal diagnosis, the introduction of minimal invasive surgery, in addition to the standard open repair, and the use of improved prosthetic devices for closure.

scholarly journals Right-sided congenital diaphragmatic hernia – the experience of the neonatal surgery center

2020 ◽  
pp. 13-23
Author(s):  
O. Sliеpov ◽  
◽  
O. Ponomarenko ◽  
M. Migur ◽  
L. Sliеpova ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Low Frequency ◽  
State Institution ◽  
Medical Sciences ◽  
Results Of Treatment ◽  
The Difference ◽  
Surgery Center ◽  
Diaphragmatic Hernias

Congenital right-sided diaphragmatic hernias are a special form of diaphragmatic hernias. A relatively low frequency and features of anatomy, diagnosis clinical course, and survival characterize them. Objective: to analyze the results of treatment of right-sided diaphragmatic hernias in newborns. Materials and methods: a retrospective analysis of the medical records and autopsy protocols of 22 newborns with right-sided diaphragm defect, who were in the clinics of the State Institution «IPAG named after academician O.M. Lukyanova of the National Academy of Medical Sciences of Ukraine», was carried out for the last 37 years. Results: in 3 cases stillbirth was stated, in all live-born children (n=19) with right-sided СDH the defect was symptomatic. Moreover, in 84.2% (n=16) of them, symptoms of the disease occurred immediately after birth, in 10.5% (n=2) – from the first to 6 hours of life, in 5.3% (n=1) – after 24 hours, from birth. Signs of pulmonary hypertension were determined based on the difference between pre- and postductal peripheral blood saturation. Thus, in 62.5% (n=5) of operated children and in 63.6% (n=7) who died at the stages of stabilization, the difference in pre- and postductal saturation was more than 10%, whichindicated the presence of 100% pulmonary hypertension, and blood shunting from right to left, through fetal communications. The time of preoperative stabilization ranged from 1 to 23 days, on average 7.25 days. 8 children were operated. The surgical approach was right-sided subcostal laparotomy (n=5) or right-sided thoracotomy (n=2). In one case, there was a combined approach: right-sided laparotomy + right-sided thoracotomy. 5 children survived, 3 died. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. No conflict of interest was declared by the authors. Key words: congenital diaphragmatic hernia, right-sided, herniation of the liver, critical hypoplasia of the lungs, surgical correction, newborn baby.

scholarly journals A case of Vaccine-Induced Thrombotic Thrombocytopenia (VITT) with thrombosis of the superior mesenteric artery after ChAdOx1 nCov-19 COVID-19 Vaccine

2021 ◽  
Vol 17 (4) ◽  
Author(s):  
Laura Pini ◽  
Paolo Malerba ◽  
Jordan Giordani ◽  
Deborah Stassaldi ◽  
Carlo Aggiusti ◽  
...  
Keyword(s):  
Ct Scan ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Gastrointestinal Symptoms ◽  
Arterial System ◽  
Severe Thrombocytopenia ◽  
Rapid Improvement ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
Laboratory Investigations

We describe the case of a 64 years-old woman admitted to the Emergency Department of the ASST-Spedali Civili of Brescia with fever and gastrointestinal symptoms 10 days after the first dose of ChAdOx1 nCov-19 vaccine. Laboratory investigations showed severe thrombocytopenia and high D-dimer, while an abdominal CT scan reported a partially occluding thrombosis of the superior mesenteric artery. Following treatment with fondaparinux, immunoglobulins and high dosage steroid therapy, we observed a rapid improvement of patient’s conditions. An ELISA assay showed the presence of antibodies against heparin PF4-complex. Subsequent abdominal CT-scan showed the superior mesenteric artery thrombosis resolution, and the patient was finally discharged after 12 days of hospitalization. Several reports pointed to the venous system as the main district affected by Vaccine-Induced Thrombotic Thrombocytopenia (VITT), while a peculiar feature of this report is the involvement of the mesenteric arterial system. Further investigation of VITT’s pathophysiological mechanisms is mandatory to develop preventive strategies and effective treatments.

On the clinical picture of diaphragmatic hernias with a description of a case of a carcinomatous stomach in a hernial sac

1930 ◽  
Vol 26 (3) ◽  
pp. 267-272
Author(s):  
A. I. Kondrashkin
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Clinical Picture ◽  
Correct Recognition ◽  
Hernial Sac ◽  
Diaphragmatic Hernias

Lifetime recognition of chronic diaphragmatic hernias is rare. According to Lachers statistics in 1880. In 276 cases, accurate intravital recognition of diaphragmatic hernias was decreed only once - Leich tens ter n'om. Later, the number of such cases increased significantly, but nevertheless, their correct recognition is still very rare. These are the cases: Ahlfeld'a, Kaufmann'a, Abe 1'ya, A. V. Bergmann'a, Strupler'a, Pluckler'a, Herz'a. Here, recognition was possible, for the most part, thanks to fluoroscopy. Wullstein says in this regard that the diagnosis of congenital diaphragmatic hernia was probably never made with certainty. Thus, the description of our case in connection with the observations of other authors known from the literature may be of certain interest.

scholarly journals Massive gastric necrosis associated with delayed presentation of congenital diaphragmatic hernia—is salvage possible?

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
G. Krishna Kumar ◽  
U. Mallikarjun ◽  
D. Reshma
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Gastric Volvulus ◽  
Gastrointestinal Symptoms ◽  
Delayed Presentation ◽  
Case Presentation ◽  
Late Presenters ◽  
Vascular Compromise ◽  
Massive Necrosis ◽  
Event Occurrence

Abstract Background Delayed presentation of congenital diaphragmatic hernia is an uncommon event. Occurrence of gastric volvulus with massive necrosis in this setting is unusual. In this difficult scenario, the surgeon is faced with the dilemma of conservation or resection. Case presentation A 1-year-old boy with vague gastrointestinal symptoms was found to have congenital diaphragmatic hernia with gastric volvulus, on imaging. The stomach showed massive necrosis secondary to volvulus, and after removal of the necrotic body of the stomach, the remnant was sutured together. Conclusion Congenital diaphragmatic hernia is difficult to diagnose in late presenters beyond the neonatal period due to lack of respiratory symptoms. Stomach salvage is feasible even in severe vascular compromise due to extensive collaterals.

scholarly journals P56 Gastrointestinal manifestations of COVID-19: a retrospective analysis

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Osamah Niaz ◽  
Aaliya Uddin ◽  
Sangeetha Thomas ◽  
Katherine Harries ◽  
Sarah-Jane Walton ◽  
...  
Keyword(s):  
Ct Scan ◽  
Retrospective Analysis ◽  
Gastrointestinal Symptoms ◽  
District General Hospital ◽  
Chest Ct ◽  
Ct Scans ◽  
Abdominal Ct ◽  
Angiotensin Converting Enzyme 2 ◽  
Gastrointestinal Manifestations ◽  
Abdominal Ct Scan

Abstract Introduction Emerging data suggests that SARS-CoV-2 acts via the angiotensin-converting-enzyme-2 (ACE2) receptors in the cells, also present in the gastrointestinal and liver cells, resulting in gastrointestinal manifestations of COVID-19. It is challenging to diagnose COVID-19 in patients presenting with only gastrointestinal symptoms, with early suspicion and visualisation of the lung bases on computerised tomography(CT) abdomen scans being helpful. Methods Single-centre retrospective analysis of abdominal/chest CT scans was conducted within a District General Hospital. From the 6000 CT scans between March and April 2020, 1557(26%) were abdominal, 230 of which had chest CT scans with COVID-19 positive changes. 49 patients with CT abdomen and a positive CT Chest were shortlisted. All recorded documentation was assessed using online clinical portal and tabulated using Microsoft Excel®. Subdivision into 3 groups was: 1) primary gastrointestinal symptom, normal CT abdomen, 2) common COVID-19 symptoms with gastrointestinal symptoms, normal CT abdomen 3) gastrointestinal symptoms, abdominal pathology on radiology. Results COVID-19 related changes were seen on CT scans with no abdominal pathology noted in 33% (n = 16) patients with primary gastrointestinal symptoms. Further 18% (9 patients) presented with gastrointestinal symptoms alongside other common COVID-19 symptoms, however abdominal CT scan was normal. CT abdomen of these 25 patients were studied by a consultant radiologist, who examined the lung bases on the abdominal CT scan for COVID-19 related changes, which was seen in 92% patients. In 8% of the cases where the lung bases on the CT abdomen were normal, COVID-19 related changes were apparent on the CT chest. Conclusions CT scans of the abdomen should be supplemented with CT scans of the chest, when appropriate, for early accurate diagnosis, early treatment and triage to the correct wards, especially at the height of the pandemic.

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