Bilateral congenital anterior diaphragmatic hernia: a case report (original) (raw)

Right sided diaphragmatic hernia of Morgagni with associated anatomical abnormalities

a rare type of diaphragmatic hernia has been observed within a cadaver in the Anatomy department during routine dissections. Normally, congenital diaphragmatic hernias appear on the left side, namely a Bochdalek hernia. This particular hernia, a Morgagni type, is uniquely found on the anterior right side of the thorax. This 101-yearold female cadaveric specimen had a herniation of the greater omentum, stomach, and portion of the duodenum into the right side of the thorax, with an associated slight mediastinal shift to the left. In addition, this cadaver had a fleshy 'string' of tissue connecting the hernia sac to the sigmoid colon, a tortuous internal carotid artery, thickened costal cartilages, and weak fascia.

Congenital Diaphragmatic Hernia Associated With Uncommon Abnormalities

International Archives of Medicine, 2017

Congenital diaphragmatic hernia is a poor formation of the diaphragm characterized by the presence of an intestinal malrotation, It is related to abnormal position of the intestine in the thorax. This case report a stillborn at 32 weeks, that was observe anatomical abnormalities associated with congenital diaphragmatic hernia, which occurred in the left antero-posterior region, such as intestinal malrotation, hepatomegaly and nephromegaly, with the presence of a hernial ring that occupied 80 % of the left side of the diaphragm, besides a hypertrophied heart, deviated to the right, bilateral pulmonary hypotrophy. This case illustrates a rare case of diaphragmatic hernia with intestinal changes of clinical and surgical importance.

Bilateral congenital diaphragmatic hernia

Pediatric Surgery International, 2005

Bilateral congenital diaphragmatic hernia (CDH) is a rare condition, with the literature suggesting a bleak prognosis. We describe a case of bilateral CDH that, despite confirming the challenges of diagnosis, demonstrates that the condition can have a favourable outcome.

Congenital asymptomatic diaphragmatic hernias in adults: a case series

Journal of Medical Case Reports, 2013

Introduction: Congenital diaphragmatic hernia is a major malformation occasionally found in newborns and babies. Congenital diaphragmatic hernia is defined by the presence of an orifice in the diaphragm, more often to the left and posterolateral, that permits the herniation of abdominal contents into the thorax. The aim of this case series is to provide information on the presentation, diagnosis and outcome of three patients with late-presenting congenital diaphragmatic hernias. The diagnosis of congenital diaphragmatic hernia is based on clinical investigation and is confirmed by plain X-ray films and computed tomography scans. Case presentations: In the present report three cases of asymptomatic abdominal viscera herniation within the thorax are described. The first case concerns herniation of some loops of the large intestine into the left hemithorax in a 75-year-old Caucasian Italian woman. The second case concerns a rare type of herniation in the right side of the thorax of the right kidney with a part of the liver parenchyma in a 57-year-old Caucasian Italian woman. The third case concerns herniation of the stomach and bowel into the left side of the chest with compression of the left lung in a 32-year-old Caucasian Italian man. This type of hernia may appear later in life, because of concomitant respiratory or gastrointestinal disease, or it may be an incidental finding in asymptomatic adults, such as in the three cases featured here.

Late-onset congenital diaphragmatic hernia: A case report

International Journal of Surgery Case Reports, 2013

INTRODUCTION: A Bochdalek hernia is a posterior congenital defect of the diaphragm, usually on the left hemidiafragm, caused by a lack of closure of the pleuroperitoneal canal between the eighth and tenth week of fetal life during the embryonic development. It typically presents in the neonatal period with severe respiratory failure. PRESENTATION OF CASE: In this paper we present a 35 year old man with a 5-year history of episodes of severe dyspnea who arrived to the emergency room, during his medical work-up we incidentally found an intrathoracic gastric bubble, a laparoscopy was performed, founding a necrotic stomach and for defect correction. DISCUSSION: This pathology is infrequent in adults, among this age group, there are two different clinical presentations: asymptomatic patients who are diagnosed incidentally when abdominal organs are found in the thorax in a chest X-ray, and symptomatic patients due to side effects of incarceration, strangulation, hemorrhage and visceral perforation in the chest cavity. CONCLUSION: Diaphragmatic hernias are rare among adult population, and they are usually asymptomatic, in this case we presented a symptomatic patient, diagnosed with a chest X-ray and treated surgically. The surgical approach for the resolution of this pathology is variable and it depends on the presence and severity of visceral complications.

Late presentation of congenital diaphragmatic hernia

PubMed, 2015

Late presentation of congenital diaphragmatic hernia is 5-30% of all congenital diaphragma hernia cases. It can present as Morgagni, Bochdalek and paraesophageal hernia. Misdiagnosis can result in significant morbiditiy. A 17-month-old girl presented with vomiting and abdominal pain. On physical examination, circulatory disturbance, cyanosis, abdominal distantion were present. Her O2 saturation was 60% and she was tachycardic (180 bpm) and tachypneic (58 bpm) with hypotension (60/35 mmhg). Patient's heart and mediastinum were shifted into the right hemithorax on the chest X-ray. Bowel loops in the left hemithorax with air-fluid levels were seen in her plain X-ray and diaphragmatic hernia was seen in her computed tomography examination. She was referred to our center and operated within an hour. Herniated intestinal loops and stomach were observed from about 2 cm diameter defect of diaphragma were repaired primarily. She was extubated in postoperative 4th day. Late presentation of congenital diaphragmatic hernia may be confused with many situation and is difficult to diagnose without clinical suspicion. Accurate diagnosis and urgent treatment is lifesaving.

[Laparoscopic management of a congenital diaphragmatic hernia]

Gaceta médica de México

Morgagni diaphragmatic hernia is a birth defect whose presentation in adults is rare. Diagnosis is usually made as an incidental finding through image studies; infrequently, patients may present with symptoms such as dyspnea or retrosternal pain. Open surgical repair has been the preferred management method of symptomatic presentation. In this paper we present the case of a 42 year-old-male with symptoms of retrosternal pain and dyspnea. Diaphragmatic hernia diagnosis was made ​​by CT and it was managed by laparoscopic repair of the diaphragmatic hernia.

A Rare Case of Late Presentation of Congenital Diaphragmatic Hernia

The Journal of Medical Sciences, 2016

Congenital diaphragmatic hernia is a well-described condition that occurs in about 1 in 5,000 live births. A majority of the patients are diagnosed either antenatal or will present in the first few hours of life with respiratory distress. Presentation in adults is extremely rare and accounts for about 5 to 25% of diaphragmatic hernias. Patients, who present with late diaphragmatic hernias, complain of a wide variety of symptoms and diagnosis can be difficult. It consists of herniation of bowel, and occasionally solid organs, into the chest. It is more common on the left side (seen in 80% of cases), as the liver provides a relative barrier on the right side. The major clinical problem is pulmonary hypoplasia, a result of the lung having failed to develop in utero as the thoracic cavity is filled with abdominal contents. These congenital diaphragmatic defects have also been described in the adult population, and the widespread use of computed tomography has led to the recognition that these hernias are not uncommon and are often asymptomatic.

Diaphragmatic herniation diagnosed at a late stage: an evaluation of eight cases

Turkish Journal of Thoracic and Cardiovascular Surgery, 2012

Bu çalışmada, spesifik klinik özellikleri ve ilginç klinik ve radyolojik tabloları olan ve son evrede tanı konulduktan sonra ameliyat edilen diyafragmatik hernili hastalar analiz edildi. Ça lış mapla nı:Ocak 2006 ve Ağustos 2010 tarihleri arasında son evrede tanı konan ve kliniğimizde ameliyat edilen üçü erişkin ve beşi çocuk toplam sekiz diyafragmatik hernili olgu (4 erkek, 4 bayan; ort. yaş 12.4±24 yaş; dağılım 9 ay-28 yıl) retrospektif olarak değerlendirildi. Tüm hastalarda laparotomi ve torakotomi sonrasında herni redüksiyonu ve primer onarımı yapıldı. Bul gu lar: Çocukların tanısı neonatal dönem sonrasında konuldu. Üç olguya erişkin dönemde tanı kondu. Beş hastada sağ taraflı doğuştan Morgagni hernisi; bir hastada hiatal herni ve iki hastada sol taraflı Bochdalek hernisi mevcuttu. Ameliyattan sonra 5 ila 19. günler arasında tüm hastalar taburcu edildi. Hastanede ortalama kalış süresi 9.8 gündü (dağılım 7-23 gün). Hastalar altı ay ila iki yıl süreyle takip edildi ve anlamlı bir solunum veya gastrointestinal yakınma kaydedilmedi. Morgagni hernisi olan üç olguda da herhangi bir sorun tespit edilmedi. So nuç: Doğuştan olan diyafram hernileri, çoğunlukla neonatal dönemde görülen patolojiler olup, sonrasında bu hernilerin tanısı güçleşebilir. Takip edilen ve deneyimli uzmanlar tarafından klinik olarak tedavi edilen olgularda mortalite ve morbidite oranları düşüktür. Anah tar söz cük ler: Edinilmiş; doğuştan; diyafram; herniasyon. Background: In this study, we aimed to analyze patients with diaphragmatic hernias who had specific clinical features and interesting clinical, radiologic presentations, and had operated following late diagnosis. Methods: A total of eight diaphragmatic hernia cases, of whom three were adults and five were children (4 males, 4 females; mean age 12.4±24 years; range 9 months to 28 years), who were diagnosed in the late period and who were operated on in our clinic between January 2006 and August 2010 were evaluated retrospectively. In all patients, primary repair of the diaphragm was performed following laparotomy and thoracotomy. Results: The children were diagnosed following the neonatal period. Three patients were diagnosed in adulthood. Five patients had right-sided congenital Morgagni hernias, one patient had a hiatal hernia, and two patients had left-sided Bochdalek hernia. All patients were discharged between the 5 th and 19 th postoperative days. The average duration of hospital stay was 9.8 days (range 7 to 23 days). The follow-up time were between six months and two years, and no significant respiratory and gastrointestinal complaints were recorded. No morbidity was detected in three cases with Morgagni hernia. Conclusion: Congenital diaphragmatic hernias are pathologies which are seen in the neonatal period, and the diagnosis of these hernias can be difficult after this period. Mortality and morbidity rates are low in cases who are followed and treated in clinics by dedicated thoracic surgeon.