3.Giant Meckel's Diverticulum Associated with a Congenital Diaphragmatic Hernia.
In Suk KANG ; Soo Min AHN ; Airi HAN ; Jung Tak OH ; Seok Joo HAN ; Seung Hoon CHOI
Yonsei Medical Journal 2004;45(1):177-179
Giant Meckel's diverticulum is a very rare lesion and its association with a congenital diaphragmatic hernia has not been reported previously. We report a case of newborn with a giant Meckel's diverticulum and congenital diaphragmatic hernia. A large round atypical air-filled bowel segment was found by chest radiography preoperatively, and a giant Meckel's diverticulum was located within the left hemithorax during surgery.
Hernia, Diaphragmatic/*complications/congenital/*pathology
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Human
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Infant, Newborn
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Male
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Meckel Diverticulum/*complications/*pathology/surgery
4.The Result of Delayed Operation in Congenital Diaphragmatic Hernia.
Suk Koo LEE ; Hyun Hahk KIM ; Kyung Hun KIM ; Yun Sil CHANG ; Won Soon PARK
Journal of the Korean Association of Pediatric Surgeons 2001;7(1):21-25
Congenital diaphragmatic hernia (CDH) in the past was considered a surgical emergency requiring immediate operation. Several groups now advocate preoperative stabilization and delayed surgery. The treatment strategy for CDH in this institution is delayed surgery after preoperative stabilization. The aim of this study was to evaluate the results of delayed surgery. A retrospective review of 16 neonates with CDH was performed. Surfactant, conventional mechanical ventilation, high frequency oscillation, and nitric oxide were utilized for preoperative stabilization as necessary. The difference in outcome between two groups differentiated by the duration of the preoperative stabilization periods with mechanical ventilation (< or = 8 hours and >8 hours) was determined. Chi-square test was used to analyze the data. There were 7 right-sided hernias and 9 left. The average duration of stabilization was 32.4 hours. Hepatic herniation through the defect was found in 6 cases and all died. The most common postoperative complication was pneumothorax. The mortality rate of the right side hernia was higher than the left (85.7% vs. 33.3%, p=0.036). Mortality rate of the group (N=8) whose preoperative stabilization period was 8 hours or less was better than that (N=6) whose preoperative stabilization period was more than 8 hours (25.0% vs. 83.3%, p=0.031). The overall mortality rate was 56.3%. The better prognosis was noticed in left side hernia, no liver herniation, or shorter preoperative stabilization period.
Emergencies
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Hernia
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Hernia, Diaphragmatic*
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Humans
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Infant, Newborn
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Liver
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Mortality
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Nitric Oxide
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Pneumothorax
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Postoperative Complications
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Prognosis
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Respiration, Artificial
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Retrospective Studies
5.Traumatic diaphragmatic hernia associated with pelvic ring fracture.
Yin ZHANG ; Tao CHENG ; Hong GAO ; Xian-Long ZHANG
Chinese Medical Journal 2015;128(9):1272-1274
6.Acute Gastric Volvulus due to Diaphragmatic Hernia.
Ju Hee MAENG ; Hee Sup LEE ; Jin Gun JANG ; Bae Gun PARK ; Byung Kyu NAH ; Yong Ho KIM ; Sung Moon JUNG ; Gab Jin CHEON
The Korean Journal of Gastroenterology 2003;42(6):544-548
Gastric volvulus is an uncommon condition which is difficult to diagnose and treat. It designates abnormal rotation of the stomach along its longitudinal (organoaxial) or transverse (mesenteroaxial) axis. When the rotation exceeds 180 degrees, gastric obstruction or strangulation may occur. The classical presentation of acute gastric volvulus is the triad of severe epigastric pain, vomiting followed by retching without the ability to vomit, and difficulty or inability to pass a nasogastric tube. Delay in diagnosis and treatment of gastric volvulus can lead to fatal complications such as gastric ischemia, perforation, and hemorrhage. Gastric volvulus is a true emergency which should be treated immediately either surgically or by upper endoscopy. We report a case of an acute incarcerated gastric volvulus due to a left-sided diaphragmatic hernia in an adult male patient, which was treated successfully by operation.
Acute Disease
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Hernia, Diaphragmatic/*complications
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Humans
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Male
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Middle Aged
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Stomach Volvulus/diagnosis/*etiology
7.Clinical analysis of laparoscopic treatment of chronic traumatic diaphragmatic hernia in 29 cases.
Yu Gang CHENG ; Qiao Nan LIU ; Li LUAN ; Chang Jin CUI ; Zhi Bo YAN ; Bo LI ; Guang Yong ZHANG
Chinese Journal of Surgery 2023;61(6):474-480
Objective: To examine the safety and effectiveness of laparoscopic individualized surgical treatment for chronic traumatic diaphragmatic hernia (CTDH). Methods: The clinical data and follow-up data of 29 CTDH cases admitted to the Qilu Hospital of Shandong University or the First Affiliated Hospital of Shandong First Medical University from June 2015 to January 2023 were retrospectively analyzed. There were 21 males and 8 females, aged (49.4±17.8) years (range: 19 to 79 years). The main clinical manifestations were symptoms of the digestive system and respiratory system, and only 4 cases were asymptomatic. All patients received laparoscopic treatment (conversion to open surgery was not excluded). Intraoperative exploration (location of the hernia, contents of the hernia, diameter of the hernia ring), surgical conditions (surgical repair plan, operation time, blood loss, postoperative complications) and postoperative follow-up were analyzed and discussed. Results: Laparoscopic repair was successfully completed in 27 cases, including simple suture in 6 cases, suture and patch repair in 17 cases, the anterior abdominal wall muscle flap reversal suture and patch repair of in 3 cases, and patch bridge repair in 1 case. The operation time was (112.8±44.7) minutes (range: 60 to 200 minutes). The amount of bleeding (M(IQR)) was 35 (58) ml (range: 10 to 300 ml). The other 2 patients were converted to laparotomy. Except for one patient with transverse colon strangulation necrosis who died of aggravated pulmonary infection after surgery, the remaining 28 patients were discharged successfully. The follow-up time was 36 (24) months (range: 1 to 60 months). During the follow-up period, only two patients had occasional left upper abdominal discomfort. Twenty-seven patients with left diaphragmatic hernia had no recurrence, and the symptoms of 1 patient with right diaphragmatic hernia were relieved. Conclusion: Customized laparoscopic surgical repair for CTDH according to the location and size of the diaphragmatic defect can achieve good surgical results.
Male
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Female
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Humans
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Hernia, Diaphragmatic, Traumatic/surgery*
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Retrospective Studies
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Laparoscopy/methods*
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Postoperative Complications
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Laparotomy
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Surgical Mesh
9.A Case of Left-sided Morgagni Hernia Complicating Incarcerated Small Bowel Hernia.
Se Won KIM ; Sang Hun JUNG ; Su Hwan KANG
The Korean Journal of Gastroenterology 2008;51(1):52-55
Morgagni hernia is an uncommon presentation representing about 3% in incidene and usually located in the right-sided anterior diaphragm. We experienced a case of Morgagni hernia in a seventy four-year-old male who was admitted complaining of intermittent abdominal pain. The diagnosis was made initially by chest and abdominal radiography, and an incarcerated Morgagni hernia was finally diagnosed with abdominal CT scans. Emergent laparotomy was performed. Morgagni foramen was located on the left-sided anterior diaphragm and Morgagni hernia which contained greater omentum and strangulated small intestine was gently reducted. Morgagni foramen measuring 4x5 cm was repaired with a Gortex mesh. We reported the experience of left-sided Morgagni hernia complicating incarcerated small bowel hernia in an old male patient.
Aged
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Hernia, Diaphragmatic/diagnosis/etiology/*radiography
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Humans
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Intestinal Obstruction/complications/*diagnosis
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*Intestine, Small
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Male
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Tomography, X-Ray Computed