Strangulated Diaphragmatic Hernia in an Elderly Man

A congenital diaphragmatic hernia is very uncommon among adults. A diaphragmatic hernia is primarily acute in onset and it is usually identified after trauma. It occurs mostly on the left side. We would like to report a 68-year-old male who presented with a 4-day history of acute intestinal obstruction with a background history of change in bowel habit for a month secondary to a right diaphragmatic hernia. He did not have any history of trauma. Clinical examination revealed a distended abdomen with high pitched bowel sound and no palpable mass. The right lung was inaudible on auscultation. Computed tomography scan was consistent with a right diaphragmatic hernia and acute intestinal obstruction. We highlight the late onset of a congenital diaphragmatic hernia and emphasize the vital need for perioperative management to ensure a promising surgical outcome.

Anaesthetic Management of Non Traumatic Diaphragmatic Hernia as a Co-existing Disease: Combined Spinal Epidural to Rescue

Diaphragmatic hernia is a congenital or acquired defect in diaphragm, resulting in herniation of abdominal viscera into thoracic cavity. Acquired diaphragmatic hernia are seen mostly in patients with blunt or penetrating abdominal injuries. Nontraumatic acquired diaphragmatic hernias have been reported in literature but are extremely rare. Anaesthetic management of a patient presenting with nontraumatic diaphragmatic hernia as a co-existing disease offer unique challenges and considerations. This report was about the successful anaesthetic management of a 66-years-old male. He had Osteoarthritis (OA) of left knee with long standing massive right diaphragmatic hernia as a co-existing disease. He was scheduled for left Total Knee Replacement (TKR). Combined Spinal Epidural (CSE) with low dose Subarachnoid Block (SAB) was the anaesthetic technique of choice. Femoral sciatic block is an alternate technique of anaesthesia for such patients.

Congenital Bronchobiliary Fistula in Association with Multiple Other Congenital Anomalies: Case Report

Congenital bronchobiliary fistula (CBBF) is a rare anomaly in which a fistulous opening exists between the biliary tract and the tracheobronchial tree. CBBF may be accompanied by many congenital anomalies, with biliary system anomalies being the most common. CBBF was also reported to be associated with esophageal atresia in one case and right diaphragmatic hernia in another case. However, as far as we have known, CBBF case accompanied by multiple congenital anomalies has not been reported previously. In this article, we firstly present a case of a neonatal CBBF, incidentally diagnosed intraoperatively, accompanied by multiple congenital anomalies, including congenital diaphragmatic hernia. Secondly, we present our conclusions and updates about CBBF based on what we have learned from both our case and the literature.

Hernia diafragmática derecha complicada tras hepatectomía. Presentación de un cuadro oclusivo

Traumatic diaphragmatic hernia is an infrequent form of diaphragmatic disease. We present the case of a complicated right diaphragmatic hernia after right hepatectomy.

Congenital right diaphragmatic hernia in an adult

Diaphragmatic hernia in the absence of trauma in adults is very rare. It occurs as a result of unilateral diaphragmatic agenesis. The diagnosis of this rare condition is typically made in early infancy. However, in asymptomatic patients, the diagnosis is often delayed for months and even years. We present a case of a 27-year-old female, who was referred 48-hours after Caesarean section with suspected pulmonary embolism. Computed tomography scan revealed herniation of the liver as well as bowel loops into the right hemi-thorax. Exploration through a right thoracotomy revealed right diaphragmatic agenesis. The contents were reduced into the abdomen, and the defect was repaired using a mesh. The patient had an uneventful postoperative recovery and was discharged home 10 days later. This case highlights the acute late presentation of right diaphragmatic eventration with abdominal visceral herniation in adulthood. The condition may be triggered by the increasing size of gravid uterus.

Acquired Pediatric Right Diaphragmatic Hernia Following Automatic Implantable Cardioverter-defibrillator Placement

Diaphragmatic hernias are an uncommon occurrence in the pediatric population; however, they can cause significant morbidity and mortality if the diagnosis is missed or delayed. This case discusses the radiographic and clinical exam findings of a one-year-old patient with this pathology.