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Diaphragmatic hernia managment

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https://www.readbyqxmd.com/read/27891284/strangulated-morgagni-s-hernia-a-rare-diagnosis-and-management
#1
Malav Modi, Amit Kumar Dey, Ajay Mate, Samir Rege
Morgagni hernia is a rare type of congenital diaphragmatic hernia. It accounts for only 3% of all diaphragmatic hernias. The defect is small and hernia being asymptomatic in the majority presents late in adulthood. Obstruction or incarceration in Morgagni hernia is uncommon. We report a rare occurrence of strangulated Morgagni hernia. A 40-year-old gentleman presented to our emergency department with features of intestinal obstruction. Computed tomography of the chest and abdomen showed a strangulated right Morgagni hernia...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27872422/spleen-behind-the-heart-complicates-lung-to-head-ratio-measurement-in-left-sided-congenital-diaphragmatic-hernia
#2
Amaya M Basta, Leslie A Lusk, Roberta L Keller, Roy A Filly
In fetuses with left-sided congenital diaphragmatic hernia, intrathoracic herniation of the spleen is a common occurrence. The herniated spleen can reside posterior to the left atrium of the heart in the right hemithorax and is increasingly differentiated from the lung with the use of newer sonographic equipment. Estimation of the neonatal prognosis relies on accurate measurement of fetal lung size, particularly with commonly used measurements such as the lung-to-head ratio. Here we describe how herniation of the spleen behind the heart can complicate measurement of the lung-to-head ratio on sonography and lead to overestimation, with implications for perinatal prognostication and management...
December 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27852660/massive-symptomatic-right-sided-bochdalek-hernia-in-an-adult-man
#3
Naman Kohli, Goran Mitreski, Cheng-Hon Yap, Matthew Leong
A 22-year-old man presented to a rural hospital in Australia with right-sided pleuritic chest pain, right shoulder pain and dyspnoea. The patient had been receiving chronic asthma therapy without improvement. CT of the chest was performed after an abnormal X-ray, incidentally revealing one of the largest documented right-sided diaphragmatic hernias, with left lung compression due to mediastinal shift. The patient was definitively managed with thoracotomy alone. The contents of the hernia sac included colon and multiple loops of small bowel with a 10 cm neck...
November 15, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27756029/dual-mesh-repair-for-a-large-diaphragmatic-hernia-defect-an-unusual-case-report
#4
Metin Ercan, Mehmet Aziret, Kerem Karaman, Birol Bostancı, Musa Akoğlu
INTRODUCTION: Diaphragmatic hernia secondary to traumatic rupture is a rare entity which can occur after stab wound injuries or blunt abdominal traumas. We aimed to report successfully management of dual mesh repair for a large diaphragmatic defect. CASE REPORT: A 66-year-old male was admitted with a right sided diaphragmatic hernia which occurred ten years ago due to a traffic accident. He had abdominal pain with worsened breath. Chest X-ray showed an elevated right diaphragm...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27727001/extracorporeal-membrane-oxygenation-for-neonatal-congenital-diaphragmatic-hernia-the-initial-single-center-experience-in-taiwan
#5
Wan-Ting Hung, Shu-Chien Huang, Dania El Mazloum, Wen-Hsi Lin, Hui-Hsin Yang, Hung-Chieh Chou, En-Ting Wu, Chien-Yi Chen, Po-Nien Tsao, Wu-Shiun Hsieh, Wen-Ming Hsu, Yih-Sharng Chen, Hong-Shiee Lai
BACKGROUND/PURPOSE: Extracorporeal membrane oxygenation (ECMO) is a treatment option for stabilizing neonates with congenital diaphragmatic hernia (CDH) in a critical condition when standard therapy fails. However, the use of this approach in Taiwan has not been previously reported. METHODS: The charts of all neonates with CDH treated in our institute during the period 2007-2014 were reviewed. After 2010, patients who could not be stabilized with conventional treatment were candidates for ECMO...
October 7, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/27712890/acute-gastrointestinal-compromise-in-neonates-with-congenital-diaphragmatic-hernia-prior-to-repair
#6
Catherine Fox, Michael Stewart, Sebastian K King, Neil Patel
BACKGROUND: Congenital diaphragmatic hernia (CDH) affects 1 in 3000 live births. Modern management strategies include delayed repair of the diaphragm to permit pre-operative optimization of cardiorespiratory status. We describe a cohort of neonates in whom early emergency operative intervention was required for potentially fatal intestinal compromise. METHODS: A retrospective review was performed of all neonatal CDH patients managed at a tertiary center in an 8-year period (2005-2012)...
September 15, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27695209/intragastric-pressure-useful-indicator-in-the-management-of-congenital-diaphragmatic-hernia
#7
Kartik Chandra Mandal, Pankaj Halder, Shibsankar Barman, Rajarshi Kumar, Biswanath Mukhopadhyay, Ram Mohan Shukla
AIMS: To assess the role of measuring of intragastric pressure (IGP) during closure of congenital diaphragmatic hernia. MATERIALS AND METHODS: Thirty-two cases were included in the study (August 2008 to February 2014), and IGP has been measured intraoperatively during closure. RESULT: Patients were categorized in group A (15 patients), group B (14 patients) and group C (3 patients). In group C, IGP was more than 30 cm of water pressure and all of tehm required creation of ventral hernia and ventilator support...
October 2016: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/27635388/emergency-corrective-surgery-of-congenital-diaphragmatic-hernia-with-pulmonary-hypertension-prolonged-use-of-dexmedetomidine-as-a-pharmacologic-adjunct
#8
Badri Prasad Das, Anil Prasad Singh, Ram Badan Singh
INTRODUCTION: Underdevelopment of the lung parenchyma associated with abnormal growth of pulmonary vasculature in neonates with congenital diaphragmatic hernia results in pulmonary hypertension which mandates smooth elective mechanical ventilation in postoperative period, for proper alveolar recruitment and oxygenation, allowing lungs to mature enough for its functional anatomy and physiology. Dexmedetomidine is sympatholytic, reduces pulmonary vascular resistance and exerts sedative and analgesic property to achieve stable hemodynamics during elective ventilation...
June 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27605660/emergency-repair-of-morgagni-hernia-with-partial-gastric-volvulus-our-approach
#9
Kasra Razi, Duncan Light, Liam Horgan
Morgagni hernias are a rare form of congenital diaphragmatic hernias, thus there is paucity in literature about the diagnosis and management of the condition. We report an 83-year-old woman who presented with vomiting and a metabolic acidosis with a previous computed tomography diagnosis of Bochdalek's hernia. Diagnostic laparoscopy revealed a Morgagni hernia containing transverse colon, greater curvature of the stomach and a partial gastric volvulus. The hernia was reduced with the sac untouched, and the defect was closed with a composite mesh using tac fixation...
2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27595907/anesthesia-for-traumatic-diaphragmatic-hernia-associated-with-corneal-laceration
#10
Reza Safaeian, Valiollah Hassani, Hamid Reza Faiz
BACKGROUND Diaphragmatic rupture can be seen in up to 5% of car accidents, and 80%-100% of diaphragmatic hernias are associated with other vital organ injuries. Brain, pelvis, long bones, liver, spleen, and aorta are some other organs that can be severely damaged and need different anesthetic managements. CASE REPORT A 37-year-old male victim of a head-on collision who was suffering diaphragmatic rupture and corneal laceration was prepared for an emergency operation 11 hours after the car accident. Gastric decompression, pre-oxygenation, rapid sequence induction with succinylcholine, immediate use of non-depolarizing muscle relaxant, and mechanical ventilation with low tidal volume after intubation were used in anesthetic management of the patient...
2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27521424/clinically-relevant-timing-of-antenatal-sildenafil-treatment-reduces-pulmonary-vascular-remodeling-in-congenital-diaphragmatic-hernia
#11
Daphne S Mous, Heleen M Kool, Marjon J Buscop-van Kempen, Anton H Koning, Oleh Dzyubachyk, Rene M H Wijnen, Dick Tibboel, Robbert J Rottier
Patients with congenital diaphragmatic hernia (CDH) suffer from severe pulmonary hypertension attributable to altered development of the pulmonary vasculature, which is often resistant to vasodilator therapy. Present treatment starts postnatally even though significant differences in the pulmonary vasculature are already present early during pregnancy. We examined the effects of prenatal treatment with the phosphodiesterase-5 inhibitor sildenafil on pulmonary vascular development in experimental CDH starting at a clinically relevant time...
October 1, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/27512848/delayed-traumatic-diaphragmatic-hernia-a-case-series-report-and-literature-review
#12
Jing Lu, Bo Wang, Xiangming Che, Xuqi Li, Guanglin Qiu, Shicai He, Lin Fan
BACKGROUND: Traumatic diaphragmatic hernias (TDHs) are sometimes difficult to identify at an early stage and can consequently result in diagnostic delays with life-threatening outcomes. It is the aim of this case study to highlight the difficulties encountered with the earlier detection of traumatic diaphragmatic hernias. METHODS: Clinical data of patients who received treatment for delayed traumatic diaphragmatic hernias in registers of the First Affiliated Hospital of Xi'an Jiaotong University from 1998 to 2014 were analyzed retrospectively...
August 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27502341/an-unusual-diaphragmatic-hernia-with-gastric-perforation-and-sub-acute-presentation
#13
Z Vinnicombe, M Little, A Wan
Gastric perforation into the thoracic cavity through a diaphragmatic hernia is rare but, when it occurs, patients present in severe distress, with mortality approaching 50%. We present a unique case in which a fibrotic reaction between the stomach and the parietal pleura led to a subacute presentation upon perforation. The extra time that this afforded led to more effective multidisciplinary team management and ultimately an excellent outcome for the patient.
August 9, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27445516/coexistent-congenital-diaphragmatic-hernia-with-extrapulmonary-sequestration
#14
Nao Kawamura, Samarjeet Bhandal
Bronchopulmonary foregut malformations are a heterogeneous but interrelated group of abnormalities that may contain more than one histologic feature. It is helpful to be familiar with the presentation and imaging features of bronchopulmonary foregut malformations presenting as a congenital mass or mass-like lesion, as imaging plays a central role in the evaluation of these lesions since, when symptomatic, clinical features are usually nonspecific. With imaging, the presence of other associated lesions can be determined, facilitating appropriate management to prevent the potential complications...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/27378767/fertility-pregnancy-and-gynecological-outcomes-after-fetoscopic-surgery-for-congenital-diaphragmatic-hernia
#15
C Gregoir, A C Engels, O Gomez, P DeKoninck, L Lewi, E Gratacos, J A Deprest
STUDY QUESTION: What is the impact of fetoscopic surgery for isolated Congenital Diaphragmatic Hernia (CDH) on future reproductive and gynecological outcomes? SUMMARY ANSWER: We did not observe an increase of obstetric or gynecological problems after fetoscopic surgery nor was there an increased risk for subsequent infertility. WHAT IS KNOWN ALREADY: The reproductive and gynecological outcomes of patients undergoing open maternal-fetal surgery are known...
September 2016: Human Reproduction
https://www.readbyqxmd.com/read/27376883/improved-pulmonary-function-in-the-nitrofen-model-of-congenital-diaphragmatic-hernia-following-prenatal-maternal-dexamethasone-and-or-sildenafil
#16
Carmen Mesas Burgos, Erik G Pearson, Marcus Davey, John Riley, Huimin Jia, Pablo Laje, Alan W Flake, William H Peranteau
BACKGROUND: Pulmonary hypoplasia and hypertension is a leading cause of morbidity and mortality in congenital diaphragmatic hernia (CDH). The etiologic insult occurs early in gestation highlighting the potential of prenatal interventions. We evaluated prenatal pharmacologic therapies in the nitrofen CDH model. METHODS: Olive oil or nitrofen were administered alone or with dexamethasone (DM), sildenafil, or DM+sildenafil to pregnant rats. Newborn pups were assessed for lung function, structure and pulmonary artery (PA) flow and resistance...
October 2016: Pediatric Research
https://www.readbyqxmd.com/read/27342009/right-versus-left-sided-congenital-diaphragmatic-hernia-a-comparative-outcomes-analysis
#17
Emily A Partridge, William H Peranteau, Lisa Herkert, Norma Rendon, Haylee Smith, Natalie E Rintoul, Alan W Flake, N Scott Adzick, Holly L Hedrick
PURPOSE: Right-sided congenital diaphragmatic hernia (R-CDH) occurs in up to 25% of all CDH cases, but has been less widely studied compared to left-sided defects. We sought to compare characteristics and outcomes of left- versus right-sided defects in a large cohort of CDH patients who underwent standardized treatment and follow-up at a single institution. METHODS: We retrospectively reviewed charts of all CDH patients in our pulmonary hypoplasia program from January 2002 through December 2014...
June 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27312047/lung-size-and-liver-herniation-predict-the-need-for-extra-corporeal-membrane-oxygenation-but-not-pulmonary-hypertension-in-isolated-congenital-diaphragmatic-hernia-a-systematic-review-and-meta-analysis
#18
Francesca Maria Russo, Mary Patrice Eastwood, Richard Keijzer, Jamila Al-Maary, Jaan Toelen, Tim Van Mieghem, Jan A Deprest
OBJECTIVES: To identify antenatal predictors of persistent pulmonary hypertension (PPH) and need for extracorporeal membrane oxygenation (ECMO) in fetuses with congenital diaphragmatic hernia (CDH). MATERIAL AND METHODS: We performed a systematic literature review of antenatal diagnostic tests in fetuses with isolated CDH. The target conditions were PPH within 28 days of life and the need for ECMO. Quality of studies was assessed with the QUADAS-2 tool. Meta-analysis was performed when at least three studies reported on the same test...
June 17, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27300205/genotype-phenotype-analysis-of-pediatric-patients-with-wt1-glomerulopathy
#19
Yo Han Ahn, Eu Jin Park, Hee Gyung Kang, Seong Heon Kim, Hee Yeon Cho, Jae Il Shin, Joo Hoon Lee, Young Seo Park, Kyo Sun Kim, Il-Soo Ha, Hae Il Cheong
BACKGROUND: WT1 is one of the genes commonly reported as mutated in children with steroid-resistant nephrotic syndrome (SRNS). We analyzed genotype-phenotype correlations in pediatric SRNS patients with WT1 mutations. METHODS: From 2001 to 2015, WT1 mutations were detected in 21 out of 354 children with SRNS by genetic screening (5.9 %). The patients were grouped into missense (n = 11) and KTS splicing (n = 10) mutation groups. RESULTS: Nine (82 %) patients with missense mutations presented with congenital/infantile nephrotic syndrome, while 8 (80 %) with KTS splicing mutations presented with childhood-onset SRNS...
June 14, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27261559/rate-of-increase-of-lung-to-head-ratio-over-the-course-of-gestation-is-predictive-of-survival-in-left-sided-congenital-diaphragmatic-hernia
#20
Emily A Partridge, William H Peranteau, Lisa Herkert, Natalie E Rintoul, Alan W Flake, N Scott Adzick, Holly L Hedrick
PURPOSE: Congenital diaphragmatic hernia (CDH) is associated with high postnatal mortality because of pulmonary hypoplasia. The prognostic utility of serial lung-to-head circumference measurements as a marker of lung growth has not been described. Our objective was to examine the relationship between the rate of interval increase of LHR and postnatal survival in left-sided CDH. METHODS: We retrospectively reviewed charts of all left-sided CDH patients from January 2004 to July 2014...
May 2016: Journal of Pediatric Surgery
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