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Chitralekha Patra, Naveen G Singh, N Manjunatha, Anand Bhatt
Eventration of the diaphragm is a rare entity, characterised by abnormal elevation of a dome of diaphragm. In this condition, the diaphragm is composed of fibrous tissue with few or no interspersed muscle fibres. Eventration can be congenital or acquired. Congenital eventration results from inadequate development of muscles or absence of phrenic nerve. The common cause of acquired eventration is injury to the phrenic nerve from traumatic birth injury or surgery for heart disease. The perioperative anaesthetic management of diaphragmatic eventration along with ventricular septal defect with severe pulmonary hypertension makes this case both challenging and unique...
February 2018: Indian Journal of Anaesthesia
Daisuke Ieda, Ikumi Hori, Yuji Nakamura, Hironori Ohshita, Yutaka Negishi, Tsutomu Shinohara, Ayako Hattori, Takenori Kato, Sachiko Inukai, Katsumasa Kitamura, Tomoki Kawai, Osamu Ohara, Shinji Kunishima, Shinji Saitoh
INTRODUCTION: Filamin A (FLNA) is located in Xq28, and encodes the actin binding protein, filamin A. A mutation in FLNA is the most common cause of periventricular nodular heterotopia (PVNH), but a clear phenotype-genotype correlation has not been established. Indeed, some patients with a FLNA mutation have recently been shown to additionally have Ehlers-Danlos-like collagenopathy or macrothrombocytopenia. In an attempt to establish a clearer correlation between clinical symptoms and genotype, we have investigated a phenotype that involves thrombocytopenia in a patient with a truncation of the FLNA gene...
February 12, 2018: Brain & Development
V Núñez, M Romo, J L Encinas, A Bueno, B Herrero, E Antolín, L Martínez, M López Santamaría
INTRODUCTION AND OBJECTIVES: Different echographic and fetal magnetic resonance (MRI) measurements have been described in the diagnosis of associated malformations and the prognosis of congenital diaphragmatic hernia (CDH). We have reviewed our experience searching for useful isolated or combined parameters and how MRI can complement ultrasound. MATERIAL AND METHODS: We evaluated 29 fetuses with CDH. We examined ultrasonography: Lung to Head (LHR o/e) and in MRI: ipsilateral lung volume (IPV) and total expressed as percentage of observed / expected lung volume (VPT o/e) and percentage of herniated liver (PHH)...
February 1, 2018: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Hyun Woo Goo
Objective: To evaluate the technical feasibility of four-dimensional (4D) CT for the functional evaluation of the pediatric diaphragm. Materials and Methods: In 22 consecutive children (median age 3.5 months, age range 3 days-3 years), 4D CT was performed to assess diaphragm motion. Diaphragm abnormalities were qualitatively evaluated and diaphragm motion was quantitatively measured on 4D CT. Lung density changes between peak inspiration and expiration were measured in the basal lung parenchyma...
January 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Matthew S Clifton, Mark L Wulkan
Congenital diaphragmatic hernia can be approached successfully using minimally invasive techniques. Although there are may be a suggestion of higher recurrence rates with thoracoscopic repair, this may be due to the learning curve. However, open repair is associated with additional morbidity, most notably an increased rate of small bowel obstruction. Appropriate patients who have congenital diaphragmatic hernia should be offered the benefits of minimally invasive repair.
December 2017: Clinics in Perinatology
D Boccara, K SerroR, J Lefevre, M Mimoun, M Chaouat
PURPOSES: Healing after abdomino-perineal resection is often difficult, especially in patients who have undergone radiation therapy. Vaginal reconstruction is also an important issue for the women who undergo this surgery. We describe and analyze here our series of perineal reconstructions with modified Taylor flaps. Between 2010 and 2016, 68 patients (52 women, 16 men) with cancer of the anal canal (53), adenocarcinoma of the lower rectum (9), or other malignant neoplasms of the perineum underwent reconstruction with a rectus abdominis myocutaneous (RAM) flap with an inferior pedicle and an oblique skin paddle...
October 26, 2017: Annales de Chirurgie Plastique et Esthétique
J S Rajkumar, Deepa Ganesh, Anirudh Rajkumar, Akbar Syed, Venkatesan Guru
Diaphragmatic eventration is an uncommon malady, underdiagnosed and often treated only in emergent situations. Eventration of the diaphragm is best treated by plication of diaphragm with or without meshplasty. Various studies have shown that thoracoscopic plication is as efficient as laparotomy or laparoscopic plication. We present here the report of thoracoscopic diaphragmatic plication for eventration performed in the third trimester of pregnancy in a 28-year-old woman who presented with acute respiratory distress...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
C Shwaartz, E Duggan, D S Lee, C M Divino, E H Chin
Diaphragmatic eventration is an uncommon condition, usually discovered incidentally in asymptomatic patients. Even in symptomatic patients, the diagnosis can be challenging and should be considered among the differential diagnoses of diaphragmatic hernia. The correct diagnosis can often only be made in surgery. We describe the case of a 31-year-old patient with diaphragmatic eventration that was misdiagnosed as a recurrent congenital diaphragmatic hernia and review the corresponding literature.
September 2017: Annals of the Royal College of Surgeons of England
Rahul Kadam, Vsv Prasad
Intrathoracic gastric volvulus in neonatal period is a life-threatening surgical emergency. We report a case of neonate with respiratory distress and GI bleeding who was diagnosed to have congenital diaphragmatic eventration with Intrathoracic gastric volvulus.
April 2017: Journal of Neonatal Surgery
Ana Soto Sánchez, Juan Manuel Sánchez González, Luisa Gambra Michel
Eventration is an important public health problem due to its high incidence of around 12-15% in all laparotomies performed. The repair of an eventration has a 5-15% risk of complications. In recent years, the repair with prosthetic material has resulted in additional complications.
September 2017: Revista Española de Enfermedades Digestivas
Talia Glasberg, Paige Jackson, Zdena Pavlova, Srikumar Nair
Pulmonary hypoplasia is the incomplete development of lung tissue. A reduced number of lung cells, airways, and alveoli is the hallmark and can be seen unilaterally or in both lungs. The diagnosis, however, is usually made upon pathologic examination. Here we have presented a case of a term infant presenting with severe hypoxemic respiratory failure. Despite optimizing medical and respiratory management, the infant passed away at 22 hours of life. On autopsy, she was discovered to have bilateral diaphragmatic eventrations, which is a rare cause of secondary pulmonary hypoplasia...
May 30, 2017: Curēus
Megan L Donahue, Luis O Rohena
We present a patient with a 17.31 MB interstitial deletion of 6q16.3-6q22.31, who demonstrates a unique constellation of 6q- features. Among 6q- patients, he has limb reduction among the most severe reported, he is the second patient with duodenal atresia, and is the first documented case of diaphragmatic eventration.
June 2017: Clinical Case Reports
Gábor Martis, Renáta Laczik, László Damjanovich
INTRODUCTION: The eventrated, giant abdominal wall hernias represent a considerable challenge in our practice. Presently, preoperative evaluation of the musculo-aponeurotic elements of the abdominal wall by CT imaging is not part of routine planning of surgery. AIM: Evaluation of the abdominal wall hernia progression in time. Moreover, follow up the changes of the abdominal wall structures following series of intraabdominal surgeries. METHOD: Abdominal CT imaging were performed on the 1st, 3rd, 6th, 12th, 18th, and 24th postoperative months after the primary series of surgeries in the cases of 12 patients, whose reconstructive surgeries were not possible...
February 2017: Orvosi Hetilap
Johann Paulo S Guzman, Nilo C Delos Santos, Edgar A Baltazar, Allan Troy D Baquir
We present a rare case of 32year old female with congenital diaphragmatic eventeration female presenting in an adult. She had symptoms of intermittent dyspnea and occasional epigastric discomfort. Patient had no previous history of trauma. Physical examination showed bowel sound involving the left hemithorax. Imaging modalities confirmed the diagnosis of a congenital left diaphragmatic eventeration. Patient underwent plication of the diaphragm using the abdominal approach. Intra-operatively, the left diaphragm was attenuated...
2017: International Journal of Surgery Case Reports
Takeo Nakaya, Taiju Hyuga, Yukichi Tanaka, Shina Kawai, Hideo Nakai, Toshiro Niki, Akira Tanaka
BACKGROUND: Renal dysplasia is the most important cause of end-stage renal disease in children. The histopathological characteristic of dysplasia is primitive tubules with fibromuscular disorganization. Renal dysplasia often includes metaplastic cartilage. Metaplastic cartilage in renal dysplasia has been explained as occurring secondary to vesicoureteral reflux (VUR). Additionally, renal dysplasia is observed in renal dysplasia-associated syndromes, which are combinations of multiple developmental malformations and include VACTERL association...
April 2017: Medicine (Baltimore)
M de Marneffe, L Médart, L Collignon
Spiegelian hernia is a rare anterior abdominal wall hernia, described in 1764 by a Hungarian surgeon. It often remains undiagnosed because of its unusual location on the semilunar line, laterally to the rectus muscle. CT presentation is specific. Because of its high risk of strangulation, a surgical management should be proposed, even in case of fortuitous discovery. We present three cases of Spiegelian hernia, two fortuitously discovered and one detected on the occasion of a small bowel incarceration. We also evoke a similar case of eventration on the lunate line requesting the knowledge of the detailed surgical antecedents for diagnosis...
September 2016: Revue Médicale de Liège
Davor Stamenovic
Diaphragmatic plication has been a well employed method for the treatment of diaphragmatic eventration and/or paralysis. Uniportal thoracoscopic procedures seem to offer substantial benefit in terms of postoperative pain and cosmesis with similar outcomes as other surgical techniques. A 60-year-old female patient was referred to our clinic for the surgical treatment of diaphragmatic eventration of an unknown cause. The patient was referred to our institution from another hospital, where she had undergone a femoro-popliteal and crural bypass which was unsuccessful, requiring amputation of her leg...
July 1, 2017: Interactive Cardiovascular and Thoracic Surgery
V P Sazhin, D A Khubezov, A Yu Ogorel'tsev, D K Puchkov, S V Rodimov
No abstract text is available yet for this article.
2017: Khirurgiia
Tejaswini Vallabha, Mandar Dhamangaonkar, Vikram Sindgikar, Ravindra Nidoni, Harshavardhan Biradar, Aniketan Kv, Ramakant Baloorkar
North Karnataka is one of the regions with the high prevalence of HIV+ individuals. Bijapur is a district in North Karnataka with high prevalence as per fact sheets of NACO of March 2012. Better awareness, access to health care, and antiretroviral therapy have improved survival and increase in number of people living with HIV/AIDS (PLHA). Improved survival has increased their attendance to hospitals with variety of surgical problems, some known and some less known. The percentage of HIV+ individuals was 1.64 % among all admissions...
February 2017: Indian Journal of Surgery
Wendy Kim, Jesse Courtier, Cara Morin, Narendra Shet, Eric Strauch, Jane S Kim
Late-presenting or recurrent diaphragmatic defects can pose a diagnostic challenge due to varying clinical presentations. Current diagnostic approaches include plain film radiograph for initial assessment, with other imaging modalities such as fluoroscopy, ultrasound, CT and MRI mainly utilized for troubleshooting. As a radiation-free modality, MRI can provide a more definitive diagnosis in particular cases due to its ability to visualize discontinuity of the diaphragm, distinguishing it from eventration. MRI can also accurately characterize hernia contents, defect location and size...
May 2017: Clinical Imaging
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