scholarly journals Laparoscopic Repair of Congenital Diaphragmatic Hernia in Adults

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Sanjay Kumar Saroj ◽  
Satendra Kumar ◽  
Yusuf Afaque ◽  
Abhishek Kumar Bhartia ◽  
Vishnu Kumar Bhartia

Background, Aims, and Objectives. Congenital diaphragmatic hernia typically presents in childhood but in adults is extremely rare entity. Surgery is indicated for symptomatic and asymptomatic patients who are fit for surgery. It can be done by laparotomy, thoracotomy, thoracoscopy, or laparoscopy. With the advent of minimal access techniques, the open surgical repair for this hernia has decreased and results are comparable with early recovery and less hospital stay. The aim of this study is to establish that laparoscopic repair of congenital diaphragmatic hernia is a safe and effective modality of surgical treatment.Materials and Methods.A retrospective study of laparoscopic diaphragmatic hernia repair done during May 2011 to Oct 2014. Totaln=13(M/F: 11/2) cases of confirmed diaphragmatic hernia on CT scan, 4 cases Bochdalek hernia (BH), 8 cases of left eventration of the diaphragm (ED), and one case of right-sided eventration of the diaphragm (ED) were included in the study. Largest defect found on the left side was 15 × 6 cm and on the right side it was 15 × 8 cm. Stomach, small intestine, transverse colon, and omentum were contents in the hernial sac. The contents were reduced with harmonic scalpel and thin sacs were usually excised. The eventration was plicated and hernial orifices were repaired with interrupted horizontal mattress sutures buttressed by Teflon pieces. A composite mesh was fixed with nonabsorbable tackers. All patients had good postoperative recovery and went home early with normal follow-up and were followed up for 2 years.Conclusion.The laparoscopic repair is a safe and effective modality of surgical treatment for congenital diaphragmatic hernia in experienced hands.

2019 ◽  
Vol 2019 (12) ◽  
Author(s):  
Faisal Al-Zayer ◽  
Abdulla H Aljaroof ◽  
Maram Al-Marhoun ◽  
Basem Abualsaud ◽  
Mohammed Al-Zaher ◽  
...  

Abstract Diaphragmatic hernia in the absence of trauma in adults is very rare. It occurs as a result of unilateral diaphragmatic agenesis. The diagnosis of this rare condition is typically made in early infancy. However, in asymptomatic patients, the diagnosis is often delayed for months and even years. We present a case of a 27-year-old female, who was referred 48-hours after Caesarean section with suspected pulmonary embolism. Computed tomography scan revealed herniation of the liver as well as bowel loops into the right hemi-thorax. Exploration through a right thoracotomy revealed right diaphragmatic agenesis. The contents were reduced into the abdomen, and the defect was repaired using a mesh. The patient had an uneventful postoperative recovery and was discharged home 10 days later. This case highlights the acute late presentation of right diaphragmatic eventration with abdominal visceral herniation in adulthood. The condition may be triggered by the increasing size of gravid uterus.


2021 ◽  
Author(s):  
Mingming Yu ◽  
Fang Chen ◽  
Sisi Wei ◽  
Hua Xie

Abstract BackgroundIntrathoracic kidney (ITK) associated with congenital diaphragmatic hernia (CDH) is rare congenital anomaly and usually requires surgery. The surgical methods and approaches are diverse.Case presentationWe reported a case of a 5-year-old boy who was diagnosed as right-sided ITK with CDH. Surgical treatment was performed by combined thoracoscopic and laparoscopic approach. Anatomical reposition of the right kidney and nephropexy were carried out under laparoscopy, and repair of the hernia was performed under thoracoscopy. The postoperative recovery was uneventful and long-term follow-up demonstrated normal function and development of the kidney.ConclusionCombined thoracoscopic and laparoscopic approach is minimally invasive and effective for treatment of ITK associated with CDH. It provides better visualization of the diaphragmatic foramen and the hernia sac, and can achieve anatomical reposition and fixation of the ectopic kidney.


2011 ◽  
Vol 1 (1) ◽  
pp. 6
Author(s):  
Claire R. Jackson ◽  
Gordan A. MacKinlay ◽  
Merrill McHoney

Thoracoscopic repair of congenital diaphra­gmatic hernia (CDH) has been described by a number of authors and is increasingly widely practiced. We present a technical learning point. CDH is associated with the presence of a hernia sac in around 20% of all cases. In this case the presence of a ruptured hernia sac complicated the thoracoscopic repair of a left sided CDH, as it was initially difficult to recognise. Once the anatomy was clarified the repair was satisfactorily completed and the child made a rapid postoperative recovery. This technical note is to warn other surgeons that a tunnel like appearance of the diaphragmatic defect may in fact be due to the presence of a torn hernia sac, which requires excision before closure of the defect.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Francisco Albuquerque ◽  
Pedro de Araújo Gonçalves ◽  
Hugo Marques ◽  
António Ferreira ◽  
Pedro Freitas ◽  
...  

AbstractAnomalous origin of the right coronary artery from the opposite sinus (right-ACAOS) with interarterial course (IAC) has been associated with increased risk of sudden cardiac death (SCD). Widespread use of coronary computed tomography angiography (CCTA) has led to increased recognition of this condition, even among healthy individuals. Our study sought to examine the prevalence, anatomical characteristics, and outcomes of right-ACAOS with IAC in patients undergoing CCTA for suspected coronary artery disease (CAD). We conducted a retrospective analysis of consecutive patients referred for CCTA at one tertiary hospital from January 2012 to December 2020. Patients exhibiting right-ACAOS with IAC were analyzed for cardiac symptoms and mid-term occurrence of first MACE (cardiac death, SCD, non-fatal myocardial infarction (MI) or revascularization of the anomalous vessel). CCTAs were reviewed for anatomical high-risk features and concomitant CAD. Among 10,928 patients referred for CCTA, 28 patients with right-ACAOS with IAC were identified. Mean age was 55 ± 17 years, 64% were male and 11 (39.3%) presented stable cardiac symptoms. Most patients had at least one high risk anatomical feature. During follow-up, there were no cardiac deaths or aborted SCD episodes and only 1 patient underwent surgical revascularization of the anomalous vessel. Right-ACAOS with IAC is an uncommon finding (prevalence of 0.26%). In a contemporary population of predominantly asymptomatic patients who survived this condition well into adulthood, most patients were managed conservatively with a low event rate. Additional studies are needed to support medical follow-up as the preferred option in this setting.


2020 ◽  
Vol 30 (1) ◽  
pp. 121-122
Author(s):  
Niraj N. Pandey ◽  
Mumun Sinha ◽  
Sanjeev Kumar

AbstractWe present a case of a 7-month-old boy with tetralogy of Fallot associated with unilateral pulmonary aplasia and herniation of the liver and small bowel loops in the right hemithorax.


2018 ◽  
Vol 8 (1) ◽  
pp. 44-47
Author(s):  
Bishownath Sharma ◽  
Dipesh Gupta

Bochdalek hernia is the most common congenital diaphragmatic hernia that typically presents in childhood. However, right sided diaphragmatic hernia is relatively rare. We review the case of 21 years old female with incidentally detected congenital diaphragmatic hernia on the right side. There are fewer than 20 cases of right sided diaphragmatic hernia reported in adults in literature.


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