Postsurgical diaphragmatic herniation: A rare delayed complication of pediatric intraabdominal surgery

Yazdani, Milad; Park, Ellen; Udayasankar, Unni K.

doi:10.1016/j.jpedsurg.2015.11.019

Cited by 5 publications

(6 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are many risk factors mentioned in literature that may be primarily responsible for DH after PLTs. One of them is the use of LL or LLL graft, which make right diaphragma vulnerable to high intra‐abdominal pressure . But it is not a primarily major contributory reason because if it were the case, then all right hepatectomy donors and LL adult LT recipients would have the same rate of acquired DH.…”

Section: Discussionmentioning

confidence: 50%

“…Therefore, the physicians in the field should have a low threshold in ordering specific imaging techniques in patients with complaints suggesting obstruction due to some kind of internal herniation. Wide variety of symptoms have been reported from asymptomatic situations to respiratory distress and symptoms of intestinal obstruction including nausea, vomiting, and abdominal pain …”

Section: Discussionmentioning

confidence: 99%

“…It is now widely accepted that vast majority of DHs after LT is a complication among children. There are mentioned causes of this complication in literature including large‐for‐size LL grafts, malnutrition, thermal injury on diaphragm, and IS after LT . High‐volume centers should share their experience regarding DH, as it is a rare entity.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Diaphragmatic hernias after pediatric liver transplantation: Experience of a high‐volume transplant center

Karakas

Sahin

Kutlutürk

et al. 2020

Pediatric Transplantation

View full text Add to dashboard Cite

Diaphragmatic hernias (DHs) are rare complications after pediatric liver transplantation (PLT). It is now widely accepted that DHs after liver transplantation (LT) is a pediatric related condition. PLTs (under of age 18) performed between January 2013 and June 2019 at Malatya Inonu University Institute of Liver Transplantation were retrospectively scanned. Study group consisting DHs and a control group were compared. Among 280 PLTs, 8 of them were complicated with DHs (%2.9). Median age of the patients with DH was 3.0 (0.8‐9.5) years. Median graft recipient weight ratio was 2.5 (0.9‐4.4). Five patients were below 5th percentiles in terms of pediatric weight growth chart at the time of LT. Also, 6 patients were below 5th percentiles in terms of pediatric height growth chart. There was no statistical difference between study and control groups. There are many risk factors mentioned in literature that may be primarily responsible for DHs after PLT. These factors are left lobe and large‐for‐size grafts, malnutrition, trauma or diathermy of diaphragmatic nerve and vessels and immunosuppressants. In our study, we could not specify any reason that differs in DHs. In our aspect, narrow diaphragma and thorax are exposed to high intra‐abdominal pressure from abdomen. Large‐for‐size grafts, which are specific to children, also may contribute to this affect. Excessive diathermy and trauma to diaphragmatic collaterals may aggravate the risk of DH. More patients are needed to make an exact conclusion, in order to evaluate with comparable study on this aspect.

show abstract

Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Diaphragmatic hernias after pediatric liver transplantation: Experience of a high‐volume transplant center

Karakas

Sahin

Kutlutürk

et al. 2020

Pediatric Transplantation

View full text Add to dashboard Cite

show abstract

“…20 A radiographic sign that relates to DH is the presence of ipsilateral pleural effusion. 8,10,20 However, Moon et al 8 suggest that pleural effusion may occur after a hepatectomy and LT using a LLS and therefore is not specific for diagnosing DH. Yeung et al 11 reported on four cases where DH could not be identified with plain radiography.…”

Section: Discussionmentioning

confidence: 99%

“…8,9 However, to avoid duplication, we included the additional cases from Lee et al In total, 17 studies were included in our analysis. 4,5,7,8,[10][11][12][13][14][15][16][17][18][19][20][21]…”

Section: Methodsmentioning

confidence: 99%

Diaphragmatic Hernia following Pediatric Liver Transplantation: An Underappreciated Complication Prone to Recur

Waldron

Cerisuelo

et al. 2020

Eur J Pediatr Surg

View full text Add to dashboard Cite

Introduction Postoperative diaphragmatic hernia (DH) is a rare but potentially life-threatening complication following pediatric liver transplantation (LT). In the current literature, a total of 49 such hernias have been reported in 17 case series. We present eight additional cases, three of which reoccurred after surgical correction, and review the current literature with a focus on recurrence. Materials and Methods The study sample included children (<18 years of age) who underwent LT between June 2013 and June 2020 at five large transplant centers and who subsequently presented with DH. During the study period, a total of 907 LT was performed. Eight DH were recognized, and risk factors were analyzed. Results For the eight children with DH, the mean age at LT was 28.0 (5–132) months. All patients with a DH received left lateral segment split grafts except one, who received a full left lobe. The mean weight at time of LT was 11.8 (6.6–34) kg. Two patients had a primary abdominal muscle closure, and six had a temporary silastic mesh closure. All eight children presented with a right posterolateral DH. The small bowel was herniated in the majority of cases. Symptoms reported included nausea, vomiting, and respiratory distress. Two patients were asymptomatic, and discovery was incidental. All patients underwent prompt primary surgical repair. Three DH hernias (37.5%) recurred despite successful surgical correction. Conclusion DH following liver transplant with technical variant grafts may be underreported and is prone to recur despite surgical correction. A better understanding of the pathophysiology and more thorough reporting may help increase awareness. Early detection and prompt surgical management are the cornerstones of a successful outcome.

show abstract

Pulmonary Complications of Solid Organ Transplantation

Szentpetery

Weiner

Kurland

2017

Pulmonary Complications of Non-Pulmonary Pediatric Disorders

View full text Add to dashboard Cite

Postsurgical diaphragmatic herniation: A rare delayed complication of pediatric intraabdominal surgery

Cited by 5 publications

References 8 publications

Diaphragmatic hernias after pediatric liver transplantation: Experience of a high‐volume transplant center

Diaphragmatic hernias after pediatric liver transplantation: Experience of a high‐volume transplant center

Diaphragmatic Hernia following Pediatric Liver Transplantation: An Underappreciated Complication Prone to Recur

Pulmonary Complications of Solid Organ Transplantation

Contact Info

Product

Resources

About