• Advances in pediatric surgery
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• 제6권1호
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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.

• Journal of Chest Surgery
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• 제15권4호
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• pp.432-439
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• 1982

Congenital posterolateral diaphragmatic hernia [Bochdalek hernia] is the result of a congenital diaphragmatic defect in the posterior costal part of the diaphragm in the region of the tenth and eleventh ribs. There is usually free communication between the thoracic and abdominal cavities. The defect is most commonly found on the left [90%], but may occurs on the right, where the liver often prevents detection. The male to female ratio is 2:1. Owing to the negative intrathoracic pressure, herniation of abdominal contents through the defects occurs, with resultant collapse of the lung. Shifting of mediastinum to the opposite side and compression of the opposite lung occurs. Most often these hernias are manifestated by acute respiratory distress in the newborn. A second, but less well recognized, group of patient with Bochdalek hernia survive beyond the neonatal period, usually present at a later time with "failure of thrive, intermittent vomiting, or progressive respiratory difficulty. " The diagnosis can often be made on clinical ground from the presence of respiratory distress, absence of breath sounds on the chest presence of bowel sounds over the chest . Roentgenogram of the chest confirm the diagnosis. Obstruction and strangulation have been reported but are rare. Treatment consists of early reliable identification of these congenital diaphragmatic hernia with high risk and surgical repairment. and postoperative pharmacological management with extracorporeal membranous oxygenation [=ECMO] support in the period of intensive care. On the surgical approach, for defects on left side, an abdominal incision is preferred, because of the high incidence of malrotation and obstructing duodenal bands. In the neonate, the operative mortality may be appreciable, but, later repair almost always is successful. During the period from 1972 to 1982, 4 cases of congenital Bochdalek hernia were experienced at the Kyung-Hee University Hospital.

• 한국임상수의학회지
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• 제35권5호
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• pp.237-239
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• 2018

A 2 months old female Korean domestic shorthair cat weighing 1.2 kg was come to hospital because of respiratory discomfort and lethargy. Heart sounds was more intense and clear on the right side than the left. On radiographic views, loss of the normal diaphragm line, undistinguishable shadow of heart, shadow of gas-containing intestines could be observed in thoracic cavity. Diaphragmatic herniorrhaphy was performed by using propofol 8 mg/kg IV and isoflurane without any complication. On 7th day after the operation, almost all the clinical signs and radiographs including diaphragmatic line, cardiac silhouette, liver and small intestines were turned to normal.

• 한국임상수의학회지
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• 제18권1호
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• pp.61-64
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• 2001

A 1.2 kg, five-month-old, female domestic short-hair cat was referred to Seoul National University Veterinary Medical Teaching Hospital with a history of vomiting immediatley after eating. Clinical signs were depression, anorexia, severe dehydration and vomiting since weaning. According to history taking, physical examination, complete blood count, serum chemical profile and contrast radiographic study, it was diagnosed as congenital sliding esophageal hiatal hernia. Diaphragmatic plication, esophagopexy and left-sided belt-loop gastropexy were performed. Ranitidine (2 mg/kg, IV, q12h) and sucralfate suspension (20 mg/kg, PO, q6h) were administered with low-fat liquified diet to treat reflux esophagitis. Clinical signs related to esophageal hiatal hernia disappeared immediately after surgical treatment and did not recur for 4 months.

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2009년도 춘계학술대회
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• pp.221-221
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• 2009

• Journal of Chest Surgery
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• 제6권1호
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• pp.109-112
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• 1973

Bochdalek hernia is the most common congenital diaphragmatic hernia and that of the foramen of Bochdalek is rare in right side of the diaphragm. Two cases of right Bochdalek hernia were reported in literatures published in Korea. The first case was associated with hypoplasia of the lung and could not be survived. The second case [four months old male infant] was operated on August 28, 1971. at Ewha University Hospital arid survived. The third case was a three months old male infant who had been born at 8th lunar month in a private clinic. During the period of three months prior to admission this premature infant was suf-fered from mild respiratory distress measured as pneumonia. On December 20. 1972, this infant was admitted at Kyung Hee University Hospital with severe respiratory distress developed abruptly. Chest X-ray examination [barium study] demonstrated right diaphragmatic hernia. Right hemithorax was filled with intestines and right lobe of the liver which were repositioned back into the peritoneal cavity through the foramen of Bochdalek. 3. 0 cm x3.5 cm in size, and the defect was closed with interrupt mattress sutures. There was hypospadia with chordee but no other associated anomalies such as hypoplasia of the lung, malrotation or malfixation of intestines, and cardiovascular anomalies. The Postoperative hospital course was not eventful and the baby was discharged on the 14th postoperative day.

• Journal of Chest Surgery
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• 제16권3호
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• pp.399-404
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• 1983

In general, hiatal hernia is rare incidence among diaphragmatic hernia in Korea especially in pediatric group. Recently great interest in hiatal hernia has not led to common agreement concerning the pathophysiology, method of diagnosis, clinical picture, Indications, and type of treatment. At 1981 and 1983, two cases of congenital hiatal hernia [type I, III] were surgically treated,which surgical Intervention was modified Hill`s operation and gastropexy. Postoperatively, clinical and radiological examination were proved no regurgitation, no dysphagia and well passage of barium.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제12권2호
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• pp.246-250
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• 2009

평소 건강하게 지내다가 갑자기 시작된 반복적인 구토와 보채는 증상으로 5개월 여아가 병원에 내원하였고, 단순 흉부 방사선 검사에서 비정상적 음영이 좌측 흉부에서 관찰되었다. 이어 시행된 흉부 전산화 단층촬영에서 선천성 횡경막 탈장으로 진단되어, 흉부외과에서 수술적 치료 시행하였으며 수술 결과 횡경막 좌측후외방의 Bochdalek 형식의 선천성 횡격막 탈장으로 확인되었고, 수술적 치료 후 증상의 호전을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Gastric Cancer
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• 제12권1호
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• pp.49-52
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• 2012

Through the advent of surgical techniques and the improvement of laparoscopic tools including the ultrasonic activated scissor, laparoscopic gastrectomy has been increasingly used in far more cases of benign or malignant gastric lesions for the benefit of patients without compromising therapeutic outcomes. Even though possible complications provoked by the ultrasonic activated scissor can be prevented during the procedure with increasing advanced laparoscopic experience and supervision, unexpected late complications after the operations rarely occur. An extremely rare case of left incarcerated diaphragmatic hernia of the transverse colon developed in an 81-year-old female patient as a late complication, 8 months after laparoscopy-assisted total gastrectomy for gastric cancer, with laparoscopy successfully resumed and without the need to sacrifice any portion of the bowel.

• Journal of Chest Surgery
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• 제34권12호
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• pp.968-971
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• 2001

유경 대망이식술은 흉부 수술시에 효과적으로 사용되지만 수술 후 몇 가지 합병증을 일으킬 수 있다. 본 교실에서는 65세 남자 환자에서 유경 대망이식술 후 합병증으로 발생한 횡격막탈장 1례를 경험하여 보고한다. 환자는 진균성 하행흉부대동맥류의 대동맥 이식편성형술 시행 3개월 후 발생한 대동맥식도누공으로 흉부동맥류는 절제하고 상행흉부대동맥과 복부대동맥간에 우회술을 시행받고 식도누공을 봉합한 후 유경 대망판을 식도의 봉합부와 대동맥 단락부에 이식하였다. 수술 3년 뒤에 위가 횡격막으로 탈장된 것이 발견되었고 개흉술 실시하에 유경 대망판을 결찰하고 분리한 뒤 횡격막의 결손부위를 봉합하였다.