Cases reported "Hernia, Diaphragmatic"

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1/29. Gastric volvulus in childhood.

    Gastric volvulus is an uncommon condition more so in the paediatric age group. The cause of gastric volvulus may be idiopathic or secondary to various congenital or acquired conditions. In this short series of three patients, one had volvulus which was due to ligamentous laxity and mobile spleen, second had congenital postero-lateral diaphragmatic defect and the third had hiatus hernia.
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2/29. Laparoscopic repair of Morgagni-Larrey hernia in a child.

    Primary laparoscopic repair of Morgagni-Larrey hernia has been described in adult patients but not in children. This is the first report of primary laparoscopic correction in the pediatric age group without using a prosthesis. A Morgagni-Larrey hernia was found incidentally in a 3-year-old-girl. Laparoscopic correction of the defect was performed. After 6 months the patient is doing well. The chest radiograph shows complete resolution of the hernia. The laparoscopic approach allowed repair the hernia with minimal invasiveness. Laparoscopic correction is not difficult except for those hernias in which dense adhesions are present.
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3/29. Delayed presentation of congenital diaphragmatic hernia in association with group B streptococcus infection in a preterm Omani neonate.

    We present an interesting case of a preterm Omani newborn that had delayed onset of congenital diaphragmatic hernia in association with group B streptococcus infection. The association and the pathogenesis are supported by literature review. The message to follow is that any neonate with prolonged course of streptococcal pneumonia, with unusual course, should be investigated for presence of congenital diaphragmatic hernia.
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4/29. Thoracoscopic treatment for delayed presentation of congenital diaphragmatic hernia in the infant. A report of three cases.

    BACKGROUND: Delayed presentations of congenital hernia occurring outside of the neonatal period have been reported for all ages. Classically, repair of the hernia defect involves a transverse subcostal laparotomy in the pediatric age group and usually a thoracotomy in the adult. The first report describing a laparoscopic repair of a congenital diaphragmatic hernia in a 6-month-old infant was published in 1995. During the past 25 years, 17 patients with delayed presentation of congenital diaphragmatic hernias have been managed by our pediatric surgery team. The last three patients underwent surgery thoracoscopically. patients and methods: This study involved two boys (ages, 8.3 and 19 months, respectively) and one girl (age, 9 months) weighing 8 to 13 kg. All three infants underwent surgery using a thoracoscopic approach with general anesthesia. A thoracic epidural catheter was placed systematically for postoperative analgesia during the first 24 hours. Reduction of the hernia contents using one optical trocar and two operating trocars was difficult in the case without any hernia sac. In the cases with a hernia sac, reduction was easily and quickly obtained with a pleural insufflation of carbon dioxide (~8 mmHg). The hernia defect was repaired using interrupted sutures of 2/0 Ethibond. For two of the three patients, this repair was reinforced with staples in the one case and a nonresorbable mesh in the other case. RESULTS: The mean operative time was 78 min. The chest tube was removed on the first or second postoperative day and the patients were discharged on the fourth or fifth postoperative day. At the 19-month follow-up assessment in one case, the chest x-ray was perfectly normal and diaphragmatic motion also was confirmed to be normal by ultrasonography. CONCLUSIONS: The thoracoscopic approach for the repair of delayed-presentation congenital diaphragmatic hernia is feasible. Our results demonstrate the safety and efficiency of this surgery, as well as a remarkable functional and cosmetic result and a very quick recovery.
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5/29. Morgagni hernia with down syndrome: a rare association -- case report and review of literature.

    Morgagni hernia is a rare diaphragmatic hernia accounting for only 2% of the congenital diaphragmatic defects. A case of Morgagni hernia was diagnosed radiologically in a 12-months-old male with down syndrome, with recurrent respiratory distress and chest deformity. The 2-dimensional echocardiography was normal. The diagnosis of Morgagni hernia was confirmed by barium studies. The patient underwent a corrective surgery at 18 months of age following which his symptoms subsided. literature review revealed only 18 cases of Morgagni hernia with down syndrome reported till date, with age of presentation varying from neonatal age group to 12 years of age. The mode of presentations varied from asymptomatic detection to severe respiratory distress. The possible mechanism of association and its clinical implication has been discussed. The case emphasises a need for diaphragmatic hernia to be looked for as a possible cause of respiratory distress in down syndrome.
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6/29. Late-onset left diaphragmatic hernia after group B streptococcal sepsis: An unusual presentation.

    There are several reported cases of late presentations of right diaphragmatic hernia with early- as well as late-onset group B streptococcal (GBS) infections. The authors describe the first case of late-onset left diaphragmatic hernia with late onset GBS infection in a preterm infant. The diagnosis was prompted by a dramatic clinical deterioration during the recovery phase of GBS sepsis.
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7/29. diagnosis of posterolateral congenital diaphragmatic (Bochdalek) hernia by liver scintigram: case report.

    A characteristic liver scintigraphic finding was observed in a 2-month-old infant with hepatic herniation through a right-sided posterolateral congenital diaphragmatic defect (Bochdalek). The liver scintigrams showed an oblique band of decreased radioactivity dividing the liver into an inferior anteromedial portion and a superior posterolateral portion. In spite of the markedly abnormal liver scintigram, other diagnostic studies, including pneumoperitoneum abdominal radiography, remained negative. The liver scintigram can provide life-saving information in the diagnosis of congenital diaphragmatic hernia, as in the present case. The distinctive liver-scan findings among the various types of common diaphragmatic hernias are also briefly reviewed.
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ranking = 9734.9590243576
keywords = anteromedial
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8/29. Laparoscopic repair of congenital diaphragmatic hernia with prosthesis: a case report.

    We report here our experience in the treatment of a large congenital diaphragmatic hernia, an uncommon pathology, approachable by laparoscopy. The patient was a 33-year-old woman with trisomy 21 syndrome, who only complained of colicky abdominal pain and a cough for 7 months before the hospitalization. Thoracic and abdominal CT scans showed a large anteromedial diaphragmatic hernia with slippage of the colon into the mediastinum and posterior displacement of the cardiovascular structures. The patient underwent laparoscopic repair of the hernia. The colon was put back in the abdomen; the defect (8x4 cm) was repaired by a Composix mesh (PTFE-polypropylene), fixed to the diaphragm by nonabsorbable stitches and staples. The patient was discharged on the third postoperative day. The postoperative course was uneventful. Follow-up at 18 months didn't show any complications or recurrence. We believe laparoscopic repair of diaphragmatic hernia to be the elective surgical choice, because of its technical feasibility and certain intra- and postoperative advantages.
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ranking = 9734.9590243576
keywords = anteromedial
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9/29. Right-sided diaphragmatic hernia following group B streptococcal pneumonia and sepsis.

    A case of right-sided diaphragmatic hernia following group B streptococcal pneumonia and sepsis is reported herein. The clinical course was characteristic. The position of the right hemidiaphragm was initially normal. After an antecedent group B streptococcal infection, an abnormal shadow indicating either pneumonia or a pleural effusion on the chest x-ray was recognized and an elevation of the bowel and liver into the right hemithorax gradually appeared. Repair of the hernia was indicated and the postoperative result was excellent. The relationship between a delayed-onset diaphragmatic hernia and a group B streptococcal infection is still unknown. Increased intrathoracic pressure caused by mechanical ventilation coupled with an abnormal lung compliance due to inflammation may have resulted in the delayed herniation. Among various methods for diagnosis applied, chest x-ray and ultrasonography were noninvasive and useful.
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10/29. Giant Morgagnian hernia masquerading as pleural effusion.

    Morgagnian hernia is a congenital diaphragmatic hernia which occurs through anteromedial defect in the diaphragm. A 58-year-old lady was referred for surgical management of chronic massive pleural effusion. High-resolution CT scan of the chest demonstrated an anteromedial defect in the diaphragm and with contents being colon and great omentum. She required anterolateral thoracotomy and reduction of hernia with repair of formen of Morgagni with prolene mesh. Blind needle aspiration would have punctured the colon; hence the case is being reported to highlight the necessity of CT scan/ultrasound of chest in investigating a chronic massive pleural effusion much before a needle is put for aspiration blindly.
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ranking = 19469.918048715
keywords = anteromedial
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