• Title/Summary/Keyword: Diaphragm hernia

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Extralobar Supradiaphragmatic Pulmonary Sequestration Arising from the Retroperitoneum Through a Congenital Diaphragmatic Defect

  • Lee, Soojin;Cho, Jeong Su;I, Hoseok;Ahn, Hyo Yeong;Kim, Yeong Dae
    • Journal of Chest Surgery
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    • v.54 no.3
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    • pp.224-227
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    • 2021
  • Here, we report the rare case of a 13-year-old girl with a congenital diaphragmatic hernia (also known as Bochdalek hernia), which was revealed to be an extralobar pulmonary sequestration that was treated using laparoscopic and video-assisted thoracic surgery sequestrectomy and repair of the diaphragm defect after detection of a supradiaphragmatic mass connected with the retroperitoneum. The patient showed no postoperative complications at a 1-month follow-up examination.

THE TERATOLOGICAL EFFECTS OF NITROFEN ON FETUSES IN PREGNANT RATS

  • Jung, Kyu-Yong;Lee, Yong-Soon
    • Toxicological Research
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    • v.2 no.1
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    • pp.37-50
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    • 1986
  • This paper describes the effects of nitrofen (Hi-TOK), a herbicide on the fetuses of rats. The results were observed as follows: The internal soft tissue anomalies were classified as diaphragmatic hernia, cardiac malformation (T.G.V., V.S.D., S.V.), dilatation of ventricle in brain, dilatation of renal pelvis, underdevelopment of fetal lung, shortening of cortex length and increasing of immatured glomeruli counts in the fetal kidney. The heart and diaphragm appear to be the target organs.

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Traumatic Diaphragmatic Hernia: A Report of 5 Cases (외상성 횡경막 탈장: 5례 수술 보고)

  • 장순명
    • Journal of Chest Surgery
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    • v.7 no.2
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    • pp.163-168
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    • 1974
  • Five cases of traumatic diaphragmatic hernia were repaired in the Department of Thoracic Surgery, Seoul National University Hospital, during the period from 1967 to 1974. The first case, a 14-year aid girl, was diagnosed as diaphragmatic hernia during laparotomy because of jejunal perforation 3 days after traffic accident. Herniated stomach, transverse colon, spleen and left lobe of the liver were repositioned and the diaphragmatic rupture on left posterolateral portion was repaired with two layers of nonabsorbable sutures by transthoracic approach. The second case, a 26-year old man,was diagnosed immediately after traffic accident at a local clinic and transferred to this hospital 24 hours later. Herniated stomach, transverse colon and jejunum were repositioned amd diaphragmatic rupture,about 9 cm in length,from the posterolat.edge to the base of pericardium was sutured in two layers. The third case, a 26-year old man who had stab wound on the left lower lateral chest two years ago,was admitted with sudden abdominal pain and vomiting. Upper gastrointestinal series with barium meal revealed diaphragmatic hernia. The herniated stomach and transverse colon through the defect,about 3.5cm in diameter, at anterolateral portion on the left side,were repositioned and repaired with two layers of nonabsorbable sutures. The forth case, a 26-year old man, sustained blunt trauma to the chest by a roller and was transferred to the emergency room complaining of dyspnea 40 minutes after the accident. The diaphragmatic rupture extended from left midaxillary line to contralateral anterior axillary line,about 20cm long, at anterior portion of diaphragm, which was repaired with two layers, of nonabsorbable sutures. The fifth case, a 4-year old girl, had two separate diaphragmatic ruptures on both sides, which were caused by traffic accident. Immediate upper gastrointestinal series after injury showed herniated stomach, colon and spleen into left Chest cavity. Another small rupture with anterior edge of right lobe of the liver in chest cavity was noted. These were repaired with non-absorbable sutures via thoracotomy.

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Experimental Diaphragmatic Hernia and Tracheal Ligtion in a Fetal Rabbit Model (토끼에서 태아수술에 의한 횡경막탈장과 기도결찰)

  • Cho, Ma-Hae;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.6 no.1
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    • pp.1-9
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    • 2000
  • Despite of advances in perinatal management and treatment modalities congenital diaphragmatic hernia(CDH) remains a frustrating problem. Although the sheep has proven to be a reliable experimental model for the production of intrauterine CDH, the rabbit may have some advantages. These include lower cost, smaller body size, year-round availability, high number of fetuses per pregnancy, and short gestational period. To evaluate the feasibility of the rabbit model of CDH, twenty-seven pregnant New Zealand rabbits were utilized. Hysterotomy and an operative procedure for creating a diaphragmatic defect on gestational day 24 or 25, in two fetuses of each pregnant rabbit were performed. In one fetus of one cornu of the uterus, the left fetal diaphragm was excised through an open thoracotomy(DH group). In another fetus in the other cornu, CDH was created and the trachea clipped(Surgiclip, USSC, Norwalk, Conn., USA) (TL group). Delivery was by Cesarean section on 30 days of gestation. Among twenty- seven pregnant rabbits, 12 in the DH group and eight in the TL group were born alive. The most common herniated organ was the left lobe of the liver. In thee DH group, the lungs were hypoplastic with decreased lung weight/body weight ratio, reduced numbers of alveoli, thicker media of the pulmonary arteries, and immature alveoli. In TL group, the alveoli were more mature and did not differ from the control animals. In conclusion, (1) pulmonary hypoplasia develops in the fetal rabbit diaphragmatic hernia model and (2) simultaneous tracheal ligation prevents pulmonary hypoplasia.

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Intrathoracic Ectopic Liver - A case report - (흉강내 이소성 간 - 1예 보고 -)

  • Yoo, Dong-Gon;Park, Chong-Bin;Chang, Yong-Jin;Eom, Dae-Woon;Kim, Young-Ki;Kim, Chong-Wook
    • Journal of Chest Surgery
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    • v.40 no.11
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    • pp.802-804
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    • 2007
  • Although intrathoracic liver in association with a congenital diaphragmatic hernia has been well documented, the finding of intrathoracic ectopic liver tissue in the presence of an intact diaphragm is an extremely rare congenital anomaly. We have experienced a case of intrathoracic ectopic liver without any diaphragmatic hernia. A 37-year-old woman was admitted for the treatment of an incidentally detected right lung mass, A chest computed tomography scan revealed a right lower lobe lung mass close to the diaphragm, and this was suspicious for bronchial carcinoid tumor. Upon surgery, 2 round solid masses $3.5{\times}3.5 cm$ and a $2.0{\times}2.0 cm$ in size were noted, with their bottoms attached to the diaphragm dome. The masses were completely resected. Histologically, they were confirmed to be intrathoracic ectopic livers. The patient had an uncomplicated postoperative course.

Peritoneopericardial Diaphragmatic Hernias in Four Dogs (복막 심낭 횡격막 허니아의 진단 영상 4례)

  • Choi, Ji-Hye;Kim, Hyun-Wook;Jang, Jae-Young;Seo, Ji-Min;Kim, Jun-Young;Yoon, Jung-Hee
    • Journal of Veterinary Clinics
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    • v.25 no.1
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    • pp.58-63
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    • 2008
  • Peritoneopericardial diaphragmatic hernia(PPDH) is uncommon and congenital disease in dogs and cats. In PPDH, the peritoneal organs such as liver, small intestine, stomach and omentum are displaced into the congenital defect between pericardial sac and diaphragm and cause the abnormal round and enlarged cardiac silhouette. Abnormal cardiac silhouette contacts with the cranial diaphragmatic border consistently and soft tissue- and/or gas- density structures are summated over the cardiac density in radiography. The contrast medium flows from peritoneal cavity into the pericardial sac and demonstrates the herniated abdominal organs and the abnormal defect in positive peritoneography. In this study, 4 dogs was diagnosed as PPDH using radiography, peritoneography and thoracic ultrasonography and showed various clinical signs according to the kind, amount and clinical state of herniated abdominal organs.

Surgical Correction of Peritoneopericardial Diaphragmatic Hernia with Hepatic Necrosis in a Himalayan Cat (히말라얀 고양이에서 간괴사를 동반한 복막심낭횡격막 허니아의 외과적 치료)

  • Kim, Joon-young;Jeong, Soon-wuk;Park, Bo-yeon;Go, Hiw-gon;Yoon, Hun-young;Jeong, Man-bok;Han, Hyun-jung;Min Hwang;No, Byung-kuk
    • Journal of Veterinary Clinics
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    • v.21 no.1
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    • pp.45-48
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    • 2004
  • A five months old, female Himalayan cat was referred to the Veterinary Medical Teaching Hospital at Konkuk University, because of suspecting peritoneopericardial diaphragmatic hernia (PPDH). After consecutive examination, the patient was diagnosed as PPDH and hepatic dysfunction. In spite of medical therapy for a month, the serum chemistry profiles for liver enzymes (aspartate transferase: 469 U/L, alanine transferase: above analysis, gamma-glutamyl transferase: above analysis) did not decrease to the normal range. In operation, some of liver was necrotized and was adhesive to diaphragm, these were gently dissected from thoracic structures, and resected. After debriding, the edges of the defect of diaphragm were closed with a simple continuous suture pattern. One month after operation, the cat had normal condition, recovery was uncomplicated, and the serum chemistry profiles for liver enzymes decrease to the normal range.

Lamellar Body Counts in Fetal Rabbits' Experimental Diaphragmatic Hernia and Tracheal Ligation (기도결찰을 시행한 토끼 태자의 실험적 횡격막탈장에서 Lamellar body counts)

  • Chun, Yong-Soon;Jung, Soo-Jin;Lee, Jeong-Nyeo
    • Advances in pediatric surgery
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    • v.17 no.2
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    • pp.179-187
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    • 2011
  • Experimental tracheal ligation (TL) has been shown to reverse the pulmonary hypoplasia associated with congenital diaphragmatic hernia (CDH) and to normalize gas exchange. The purpose of this study was to determine whether the TL would correct the surfactant deficiency present in the fetal rabbit model of CDH by using lamellar body count. Lamellar bodies are synthesized and secreted by the type II pneumocytes of fetal lung. The phospholipids present in these bodies constitute the major component of pulmonary surfactant. Twenty-one pregnant New Zealand rabbits underwent hysterotomy and fetal surgery on gestational day 24. Two fetuses of each pregnant rabbit were operated. In the fetus of one end of bicornuate uterus, left DH was created by excision of fetal diaphragm through open thoracotomy (DH Group). In the fetus of the other end of bicornuate uterus, left DH and TL were created (TL Group). The fetuses were delivered by Cesarean section on gestational day 31. Fourteen in control group, 12 in the DH group and 13 in TL group were born alive. En bloc excision of lungs, bronchi and trachea was done in all newborn rabbits. A five Fr catheter was inserted through trachea and repeated irrigations with 10 cc normal saline were done. The irrigated fluid was centrifuged at $280{\times}g$ for 5 minutes and the lamellar bodies were counted with the upper level fluid in platelet channel of electronic cell counter. The average lamellar body counts were $37.1{\pm}14.2{\times}10^3/{\mu}L$ in control group, $11.5{\pm}4.4 {\times}10^3/{\mu}L$ in DH group, and $6.5{\pm}0.9{\times}10^3/{\mu}L$ in TL group. Lamellar body count in DH group was lower than in control group and did not increase after TL. This study shows TL has no therapeutic effect on decreased surfactant level of CDH and the pregnant rabbit is appropriate for the animal model of CDH.

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A Case Report of Gastroesophageal Reflux Disease(GERD) with Hiatal Hernia (식도열공탈장을 동반한 위식도 역류성 질환 환자 치험 1례)

  • Park, Jung-Han;Cho, Hyun-Seok;Kim, Jung-Chul;Oh, Sung-Won;Lee, Sang-Hoon;Kim, Byoung-Woo;Lee, Jae-Eun
    • The Journal of Internal Korean Medicine
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    • v.26 no.1
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    • pp.244-251
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    • 2005
  • Hiatal hernia occurs when the upper part of the stomach moves up into the chest through a small opening in the diaphragm. It causes various symptoms(heart bum, chest pain, dysphagia, vomiting etc.) when it is associated with a condition called gastroesophageal reflux disease(GERD). In this occasion, complications included bleeding because of the erosion, ulceration and inflammation of the mucosa. For treatment, there are $H_2$ blockers and proton pump inhibitors, but they have many side effects. In Oriental Medicine effectively treated cases are rare. Therefore, it is essential to seek radical agents and effective treatments for these disorders. In this case report, these disorders are approached by focusing on the deficit of 'yin(陰)'especially 'pi-yin(脾陰)'. Desired results were seen with herbal medications which enhance the 'yin(陰)', especially through 'wuyin-jian(五陰煎)' which enhances the 'pi-yin(脾陰)'. This is reported to contribute to development of future treatments.

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