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 ; Female ; Humans ; Hernia, Diaphragmatic, Traumatic/surgery* ; Retrospective Studies ; Laparoscopy/methods* ; Postoperative Complications ; Laparotomy ; Surgical Mesh

Adult ; Female ; Fractures, Bone ; complications ; Hernia, Diaphragmatic, Traumatic ; diagnosis ; etiology ; Humans ; Pelvic Bones ; injuries

Posttraumatic diaphragmatic hernia is a rare cause of large bowel obstruction, and can present weeks or years after the initial trauma. Herein, we report the case of a 28-year-old man who presented with signs and symptoms of bowel obstruction nine months after he had a stab wound to his left chest. Chest radiography showed multiple air‑fluid levels in the right upper quadrant, an air-fluid level in the left thoracic cavity and significant free air under the diaphragm. Exploratory laparotomy revealed a contaminated abdomen with perforations in the caecum and proximal transverse colon, and a 4 cm × 4 cm defect in the left posterolateral (septal) aspect of the diaphragm, which was closed with a nonabsorbable suture. Posttraumatic diaphragmatic hernias should be part of the differential diagnosis for patients with bowel obstruction, especially if there is a history of trauma. Radiography is useful in facilitating a quick diagnosis.
Adult ; Colon, Transverse ; Colonic Diseases ; diagnosis ; etiology ; Diagnosis, Differential ; Hernia, Diaphragmatic, Traumatic ; complications ; diagnosis ; Humans ; Intestinal Obstruction ; diagnosis ; etiology ; Male ; Tomography, X-Ray Computed

No abstract available.
Aged ; Chronic Disease ; Female ; Gastroparesis/complications/*diagnosis/radiography ; Gastroscopy ; Hernia, Diaphragmatic/complications/*diagnosis ; Humans ; Stomach Volvulus/*diagnosis/etiology/surgery ; Tomography, X-Ray Computed

Because of its safety and treatment effectiveness, the popularity of radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC) has gradually increased. However, some serious complications of RFA such as hepatic infarction, bowel perforation, and tumor seeding have been reported. Recently, we experienced a case of diaphragmatic hernia after RFA for HCC. A 61-year-old man with alcoholic cirrhosis was diagnosed with a 1.0 cm sized HCC in segment (S) 5 and a 1.3 cm sized HCC in S 8 of the liver. He was treated by transarterial chemoembolization and RFA. After RFA, an abdominal CT revealed a diaphragmatic defect with herniating mesentery. Twenty-two months after the RFA, the chest CT showed the diaphragmatic defect with herniating colon and mesentery. Because he had no symptoms, and surgical repair for the diaphragmatic hernia would be a high risk operation for him, we decided to treat the patient conservatively. For its great rarity, we report this case with a review of the literature.
Carcinoma, Hepatocellular/*diagnosis/*radiotherapy/therapy ; Catheter Ablation/*adverse effects ; Chemoembolization, Therapeutic ; Hernia, Diaphragmatic/*etiology/surgery ; Humans ; Liver Cirrhosis, Alcoholic/complications/*diagnosis ; Liver Neoplasms/*diagnosis/*radiotherapy/therapy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed

Epidermal Growth Factor ; physiology ; Fetal Diseases ; therapy ; Hernia, Diaphragmatic ; complications ; therapy ; Hernias, Diaphragmatic, Congenital ; Humans ; Lung ; abnormalities ; pathology ; Prenatal Diagnosis ; Pulmonary Surfactants ; pharmacology ; Tumor Necrosis Factor-alpha ; physiology

Adult ; Female ; Fetal Organ Maturity ; Hernia, Diaphragmatic ; complications ; Hernias, Diaphragmatic, Congenital ; Humans ; Infant, Newborn ; Lung ; pathology ; Myocardium ; pathology ; Pregnancy

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 ; Hernia, Diaphragmatic/diagnosis/etiology/*radiography ; Humans ; Intestinal Obstruction/complications/*diagnosis ; *Intestine, Small ; Male ; Tomography, X-Ray Computed

Child, Preschool ; Cleft Lip ; complications ; surgery ; Cleft Palate ; complications ; surgery ; Hernia, Diaphragmatic ; complications ; surgery ; Hernias, Diaphragmatic, Congenital ; Humans ; Male

PURPOSE: Perinatal mortality rates have been used as a summary statistic for evaluating child health and medical status. Neonatal mortality rates have decreased over the past 30 years in Korea. To understand the current status of neonatal surgical gastrointestinal diseases in Daegu?Busan area, we have studied about neonatal gastrointestinal diseases with their clinical features, postoperative outcome, and mortality rates. METHODS: A clinical analysis on 202 neonates who underwent neonatal surgery from January 1996 to July 2003 at Pusan National University, Kyungpook National University, Youngnam University, and Daegu Catholic University was carried out. RESULTS: The main diseases of surgical conditions were anorectal malformation (23.8%), atresia/ stenosis of midgut (13.4%) and pyloric stenosis (13.4%). The male to female ratio was 2.8:1. Thirty-five cases (17.0%) had one or more associated anomalies including congenital heart disease, cryptoorchidism, hydronephrosis, and chromosomal anomaly. Twenty cases (10.0%) were diagnosed by antenatal ultrasound. Patients with esophageal atresia had the longest hospitalization for 54.6 days. Postoperative complications occurred in 18 cases (8.9%). The main postoperative complications were wound infection (3.5%) and anastomotic leakage (2.5%). Overall mortality was 5.9%. Diaphragmatic hernia showed the highest mortality rate (37.5%), and esophageal atresia (28.6%) and omphalocele (20.0%) were followed. CONCLUSION: The current status of neonatal surgical gastrointestinal diseases in Daegu?Busan area has improved because the disease categories are various, postoperative complications and mortality rates are decreased.
Anastomotic Leak ; Busan ; Child ; Child Health ; Constriction, Pathologic ; Daegu ; Esophageal Atresia ; Female ; Gastrointestinal Diseases* ; Gyeongsangbuk-do ; Heart Defects, Congenital ; Hernia, Diaphragmatic ; Hernia, Umbilical ; Hospitalization ; Humans ; Hydronephrosis ; Infant ; Infant Mortality ; Infant, Newborn ; Korea ; Male ; Mortality ; Perinatal Mortality ; Postoperative Complications ; Pyloric Stenosis ; Ultrasonography ; Wound Infection