• Korean Journal of Veterinary Research
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• v.39 no.1
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• pp.226-229
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• 1999

A 5-month-old, 5kg, intact male mixed dog was admitted to the Veterinary Medical Teaching Hospital of the College of Veterinary Medicine Cornell University because of severe systolic murmur. On physical examination, the dog appeared to be thin and slightly small for his age. Radiographic studies with barium sulfate clearly showed the presence of loops of intestines in the pericardium. Based on these findings peritoneopericardial diaphragmatic hernia was diagnosed. Many abnormalities were found in dog's heart : ventricular septal defect, pulmonic stenosis with moderate pulmonic valve insufficiency, and mild mitral and tricuspid valve insufficiency. Puppy's longterm prognosis was fair. His intestines were removed from his pericardium and the defect in his diaphragm was closed. The surgery went smoothly and puppy recovered very nicely from anesthesia.

• Journal of Chest Surgery
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• v.13 no.1
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• pp.52-59
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• 1980

Twelve cases of traumatic diaphragmatic injuries were treated at the Chosun University Hospital from Feb. 1977 to Inn. 1980. The following results were obtained. l. Sex ratio incidence was 5:1, which male patients were predominant. 2. The age distribution at these cases, were ranged from 16 to 43 years of age, and average age was 27 years. 3. Left sided traumatic diaphragmatic injuries were far more common than right, which approximately incidence of 5:1 diaphragmatic injuries were due to blunt trauma [7 cases-traffic accident, 1 case-fall down], and stab wound [4 cases] in etiology. 4. Surgical repairs were done through only thoracotomy incision in blunt trauma cases, and through each thoracic and abdominal incision same time in 2 cases of stab wound. 5. 2 cases {16.7%] of blunt trauma were died before operation at emergency room, and no man died during or following operation. An overall mortality was 16.7%.

• Journal of Chest Surgery
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• v.26 no.10
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• pp.791-797
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• 1993

We evaluated forty cases of traumatic diaphragmatic ruptures that we have experienced from Mar. 1976 to Mar. 1992. Thirty patients were male and 10 were female[M:F=3:1]. The age distribution was ranged from 2 to 76 years with the mean age of 35 years. The traumatic diaphragmatic ruptures were due to blunt trauma in 26 cases[traffic accident 20, fall down 4, others 2] and penetrating trauma in 14 cases[stab wound 13, gun shot 1]. In the blunt trauma, 21 of 26 cases were diagnosed within 24 hours after injury and all cases except one in penetrating trauma were diagnosed within 24 hours. In the blunt trauma, the rupture site was located in the left in 20 cases and in the right in 6 cases. In the penetrating trauma, the rupture site was located in the left in 10 cases and in the right in 4 cases. The repair of 40 cases were performed with thoracic approach in 19 cases, thoracoabdominal approach in 17 cases and abdominal approach in 4 cases. The postoperative mortality was 7.5 %[3/40]. The causes of death were septic shock[1], acute renal failure[1] and hypovolemic shock[1].

• Advances in pediatric surgery
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• v.6 no.1
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• pp.60-63
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• 2000

Spontaneous rupture of the eventrated diaphragm is not common. The authors report a case of spontaneous rupture of the congenital diaphragmatic eventration. An 8 year-old girl with right congenital diaphragmatic eventration and nephrotic syndrome was seen in emergency room because of severe abdominal pain and vomiting. She had intermittent abdominal pain for 1 year. Plain chest X-ray and ultrasonography showed entrapped bowels in the right thoracic area. Exploratory laparotomy revealed a ruptured right eventration. THE displaced abdominal viscera were repositioned into the abdominal cavity and the ruptured diaphragm was trimmed and plicated. The postoperative course was uneventful. Only one case of spontaneous rupture of eventrated diaphragmatic has been reported in the English literature.

• Journal of Chest Surgery
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• v.20 no.4
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• pp.839-846
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• 1987

The records of 10 patients with traumatic diaphragmatic hernia seen from November 1977 through July 1987 were reviewed. All the patients had a transdiaphragmatic evisceration of abdominal contents into the thorax. We treated 7 male and 3 female patients ranging in age from 3 to 62 years. In 8 patients, diaphragmatic hernia followed blunt trauma and in 2 patients, stab wounds to the chest. The herniation occurred on the right side in 3 patients and on the left side in 7. All the patients sustained additional injuries: rib fractures [7 patients], additional limb, pelvic and vertebral fractures [6], closed head injury [2], lung laceration [1], liver laceration [1], renal contusion [1], ureteral rupture [1], and splenic rupture [1]. Organs herniated through the diaphragmatic rent included the omentum [6 patients], stomach [4], liver [4], colon [3], small intestine [1], and spleen [1]. For right-sided injuries, the liver was herniated in all 3 patients and the colon, in 1. in the initial or latent phase, dyspnea, diminished breath sounds, bowel sounds in the chest were noted in 4 patients, and in the obstructive phase, nausea, vomiting, and abdominal pain were found in all 3 patients. Two patients had a diagnostic chest radiograph with findings of bowel gas patterns, and an additional 8 had abnormal but nondiagnostic studies. Hemothorax, pleural effusion or abnormal diaphragmatic contour were common abnormal findings. Three patients were operated on during the initial or acute phase [immediately after injury], 4 patients were operated on during the latent or intermediate phase [3 to 210 days], and 3 patients were operated on during the obstructive phase [10 to 290 days]. Six patients underwent thoracotomy, 2 required thoracoabdominal incision, and 2 had combined thoracotomy and laparotomy. Primary suture was used to repair the diaphragmatic hernia in 9 cases. One patient required plastic repair by a Teflon felt. Empyema was the main complication in 2 patients. In 1 patient, the empyema was treated by closed thoracostomy and in 1, by decortication and open drainage. There were no deaths.

• Tuberculosis and Respiratory Diseases
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• v.66 no.3
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• pp.241-245
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• 2009

Traumatic diaphragmatic rupture is uncommon, but requires a prompt diagnosis and repair. Diaphragmatic injury is most commonly associated with automobile accidents. The diagnosis is difficult and may be delayed because there are no specific symptoms, signs, or radiographic studies that are pathognomic for diaphragmatic injury. The most important factor in the diagnosis is a high suspicion and the use of proper diagnostic studies. We report a case involving the delayed presentation of diaphragmatic rupture in a 54 year old man, requiring surgical repair 12 days following multiple blunt trauma. It should be noted that early recognition for diaphragmatic injury is important in patients with multiple trauma to avoid the potential fatal complications.

• Journal of Veterinary Clinics
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• v.31 no.6
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• pp.531-534
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• 2014

A 3-year-old intact mixed hunting dog was referred to Gyeongsang Animal Medical Center with the clinical signs of vomiting, dyspnea, anorexia. The dogs had traumatic history that wounded at abdominal wall during the wild boar hunting 2 week ago. The dogs was diagnosed as extrahepatic biliary tract obstruction (EHBO) secondary to traumatic hernia. Diagnosis was based on radiographic features of a diaphragmatic hernia on survey radiography, dilated bile duct in abdominal ultrasonography and complete recovery due to the return of displaced organs into the peritoneal cavity and repair of the diaphragmatic rent. Diagnostic imaging and surgical intervention may result in a favorable outcome in dog with post hepatic obstruction secondary to diaphragmatic hernia. This case emphasizes the strangulation of bile duct by diaphragmatic rupture could be the cause of EHBO.

• Journal of Sasang Constitutional Medicine
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• v.24 no.1
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• pp.66-74
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• 2012

1. Objectives : The purpose of this case study is to report that the general symptoms in 83 years-old female pateint with diaphragmatic hernia improved through oral administration of Taeeumjowi-tang(太陰調胃湯) 2. Methods : We considered the patient as Taeeumin, and administered Taeeumjowi-tang(太陰調胃湯) to improve chief complaints, such as general weakness, anorexia, sense of distension, dyspnea. The change of symptoms were evaluated by VAS(visual analogue score). 3. Results : The patient received hospital treatment for 4 weeks, and the chief complaints such as general weakness, anorexia, sense of distension, dyspnea improved in general 4. Conclusions : The patient with the above symptoms (general weakness, anorexia, sense of distension, dyspnea) was confirmed as diaphragmatic hernia by chest CT scan. But the patient decided not to have surgical operation. Observating the progress, we treated the patient through oral administration of Taeeumjowi-tang(太陰調胃湯), acupuncture and moxibustion treatment. And the general symptoms improved.

• Journal of Chest Surgery
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• v.28 no.4
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• pp.381-386
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• 1995

In our hospital we have seen 20 cases of congenital diaphragmatic anomalies from June 1984 until December 1993. These were classified into 10 cases of diaphragmatic eventration, 8 cases of Bochdalek hernia, 1 case of Morgagni hernia, and 1 case of esophageal hiatal hernia. Diaphragmatic eventration cases were composed of 8 males and 2 females with ages varing from 3 hour to 42 year. They were discovered by symptoms: 5 cases of respiratory insufficiency; 3 cases of frequent respiratory infection; and 2 cases by chance; 6 cases involved the left side, 4 cases involved right side. Emergency operations were done to 4 patients. Among the 10 patients, only one operative mortality occurred; 3 hour old female.Bochdalek hernia cases composed 6 females and 2 males, 5 patients were less than 6 hour old. All patients were operated on an emergency status and three of them expired due to the vicious cycle of pulmonary hypertension and pulmonary vasoconstriction, persistent fetal circulation, hypoxia, and metabolic acidosis. Morgagni hernia was seen in one 69 year old female patient, she had no complaint of symptoms and was incidentally detected. Hernia was repaired through right thoracotomy. She was discharged with healthy appearence. Esophageal hiatal hernia was seen in a 10 month old male patient, his symptoms were persistent vomiting and coughing since birth. Sliding type of esophageal hiatal hernia repair was completed through left thoracotomy.

• Advances in pediatric surgery
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• v.4 no.1
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• pp.67-73
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• 1998

Although diaphragmatic eventration in newborn infants is generally regarded as a rare condition, the need for accurate diagnosis and appropriate intervention according to the etiological factors is well known. Recently the authors experienced five consecutive cases of diaphragmatic eventration below the age of two months(one to 55 days) requiring surgery. All were in males, and were left sided. Respiratory symptoms were present in 4 patients, and one patient showed inability to gain weight. Diaphragms were elevated to the level of the third to fifth intercostal spaces. Diaphragmatic plication through the abdomen gave excellent results. There was no postoperative mortality.