Laparoscopic management of acute presentations of obstructed, congenital, diaphragmatic hernias in adults: case reports

Mittal, Aaina; Cay, Peter; Singh, Krishna Kant

doi:10.21037/ales.2019.11.05

Cited by 4 publications

(6 citation statements)

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“…19 Chronic herniation of abdominal organs causes the attachment of organs to the walls or viscera of the thoracic cavity, so that through a thoracotomy approach it is easier to perform adhesiolysis and repair of the defect. 2,7 In this patient there was an adhesion of the hernia sac with the lung. The thoracotomy approach was chosen because it is easier and safer to reduce organ herniation and repair chronic diaphragmatic defects.…”

Section: Discussionmentioning

confidence: 83%

“…18 The thoracoscopy approach is the preferred procedure because of its lower morbidity and complication rates. 7 In patients with a diagnosis of chronic traumatic diaphragmatic hernia, thoracic surgery is recommended. 19 Chronic herniation of abdominal organs causes the attachment of organs to the walls or viscera of the thoracic cavity, so that through a thoracotomy approach it is easier to perform adhesiolysis and repair of the defect.…”

Section: Discussionmentioning

confidence: 99%

“…6 The occurrence of this developmental abnormalities process can lead to congenital defects, the most common type is failure fusion of the Bochdalek's foramen. 4,7 This condition can be diagnosed after birth, but 10% of cases can occur in adulthood. 6 A study of an elderly population in Japan showed the median age at diagnosis of Bochdalek's hernia was 58 years.…”

Section: Introductionmentioning

confidence: 99%

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Operative management of traumatic rupture of diaphragma in elderly with Bochdalek hernia: a rare case report

Hotiatun,

Sinuraya,

Hayuningrat

et al. 2024

Int Surg J

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Diaphragmatic hernia is a displacement of the abdominal viscera organs into the thoracic cavity due to a defect in the diaphragm. The most common type is failure fusion of the Bochdalek’s foramen. We report the case of a 76-year-old woman with discomfort in the right chest area since 1.5 months ago. Shortness of breath and nausea accompanied the complaints. The patient admitted that eight months before hospital admission, she was hit by a motorbike, fell towards the back, and hit her back. After the incident, the patient reported one episode of hematemesis and melena. On physical examination, the conjunctiva was pale. The anterior and posterior thoracic regions appeared asymmetrical, the fremitus was asymmetrical, and there was increased diaphragmatic excursion with bowel sounds on the right thorax. An image that leads to a right Bochdalek hernia was obtained on thoracic multi slice computed tomography (MSCT) with contrast. The patient underwent thoracotomy and diaphragm repair using mesh. The thoracic approach aims to reduce visceral-pleural adhesions and visceral intrathoracic perforation. Right-sided Bochdalek hernia in the elderly is rare, but trauma is very likely to occur and worsen the patient's condition. Late diagnosis and inadequate management are associated with incarceration and strangulation with high mortality rates. In this case, thoracotomy approach proved to be a useful method for hernias due to chronic defects in the diaphragm.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Operative management of traumatic rupture of diaphragma in elderly with Bochdalek hernia: a rare case report

Hotiatun,

Sinuraya,

Hayuningrat

et al. 2024

Int Surg J

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“…Repair of the diaphragmatic defect can be achieved with the use of sutures for primary closure or with the use of a synthetic or biological mesh to cover the defect. Mesh repair is indicated when the defect is too large for primary closure [ 3 ]. Currently, there is no clear consensus for when to use primary closure versus mesh repair, or whether transabdominal or transthoracic surgical approach is superior.…”

Section: Discussionmentioning

confidence: 99%

Morgagni hernia: an uncommon pathology in adults

Rajkumar

Kulkarni

Talishinskiy

2022

Journal of Surgical Case Reports

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Typically, diaphragmatic hernias occur as congenital defects and are considered a rare presentation when seen in adults. They occur as developmental defects and stem from embryonic components of the diaphragm not fusing completely. There are two types of diaphragmatic hernias, classified based on the location of herniation through the diaphragmatic defect. Bochdalek hernias present as defects in the left postero-lateral diaphragm, whereas Morgagni hernias present as anterior defects of the diaphragm. The more common defect of the two are Bochdalek hernias making Morgagni hernias a rare presentation. This case describes the presentation of a hernia through an anterior defect in the diaphragm, otherwise classified as a Morgagni hernia.

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“…Congenital diaphragmatic hernias are classified into four types: posterolateral hernia of Bochdalek, peritoneal pericardial hernia, diaphragmatic eventration, and Morgagni-Larrey parasternal hernia. Bochdalek hernia is the most common hernia type of congenital diaphragmatic hernia is Bochdalek hernia [5]. It occurs when the posterolateral side of the pleuroperitoneal canal fails to close in a time spam of 8 to 10 weeks of gestation.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic diaphragm repair with bioabsorbable mesh in congenital and acquired diaphragmatic hernia

Khan¹,

Ahmed²,

Saeed³

et al. 2023

ijhs

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Background and Aim: Congenital or acquired diaphragmatic hernias are both possible. The present study aimed to investigate the superiority of laparoscopic surgery over open repair of congenital diaphragmatic hernias with bioabsorbable mesh in congenital and acquired diaphragmatic hernia. Patients and Methods: This retrospective study was conducted on 7 diaphragmatic hernia cases in the General Surgery Unit of Federal Government Polyclinic Hospital, Islamabad from January 2015 to December 2022. Diaphragmatic hernia was diagnosed and confirmed on CT scan. Patients with Bochdalek hernia (BH), right-sided eventration of diaphragm, and left eventration of diaphragm (ED) cases were enrolled. Individual demographic details, clinical manifestations, hernia description, treatment modalities, and complications were recorded. Results: The overall mean age was 42 years with an age range 30-62 years. Of the total cases, there were 6 (85.7%) male and 1 (14.3%) female. The incidence of Bochdalek hernia (BH), left-sided ED, and right-sided ED was 2 (28.6%), 4 (57.1%), and 1 (14.3%) respectively. The major defect on left and right side was 15× 7 cm and 15× 8 cm respectively.

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Laparoscopic management of acute presentations of obstructed, congenital, diaphragmatic hernias in adults: case reports

Cited by 4 publications

References 0 publications

Operative management of traumatic rupture of diaphragma in elderly with Bochdalek hernia: a rare case report

Operative management of traumatic rupture of diaphragma in elderly with Bochdalek hernia: a rare case report

Morgagni hernia: an uncommon pathology in adults

Laparoscopic diaphragm repair with bioabsorbable mesh in congenital and acquired diaphragmatic hernia

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