Right-sided diaphragmatic hernia in infants after liver transplantation

McCabe, Amanda J.; Orr, John D.; Sharif, Khalid; Goyet, Jean de Ville de

doi:10.1016/j.jpedsurg.2005.03.063

Cited by 35 publications

(55 citation statements)

References 16 publications

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“…First, small infants who are candidates for transplant are usually critically ill, with at least onehalf already hospitalized or on mechanical support while waiting for a transplant. 3,8 They have low weight and typically have severe malnutrition (as was the case with 2 of our reported patients) and have generalized reduced muscle bulk. 9 It is therefore likely that their diaphragm is quite thin and may be more sensitive to the effects of diathermy, resulting in an area of focal necrosis.…”

Section: Discussionsupporting

confidence: 64%

“…Despite the division or reduction of the liver, slightly oversized liver grafts are used, and it is not uncommon that prosthetic abdominal closure is required to deal with tight abdominal closure. 3 The combination of ischemia caused by diathermy and that from abdominal overpressure might lead to focal diaphragmatic necrosis, progressing later to eventration or herniation.…”

Section: Discussionmentioning

confidence: 99%

“…The use of a segmental graft may increase the risk of diaphragmatic hernia because the surgically damaged right hemidiaphragm often remains exposed to underlying viscera, instead of being covered by the right hepatic lobe. 3 Smaller patients are therefore at risk for higher rates of diaphragmatic complications after pediatric liver transplant, 1 but diaphragmatic hernia has not been reported as a unique occurrence. Here, we report 3 cases of diaphragmatic hernia after liver transplant and discuss the possible contributing factors.…”

Section: Introductionmentioning

confidence: 99%

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Kırnap

Akdur²,

Özçay³

et al. 2015

Exp Clin Transplant

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Diaphragmatic hernia is an unusual complication after pediatric liver transplant. Nearly half of bowel obstruction cases, which require surgical intervention in liver transplant patients, are caused by diaphragmatic hernia. The smaller patients are at risk for higher rates of diaphragmatic complication after pediatric liver transplant, but diaphragmatic hernia has not been reported as a unique occurrence. Here, we report 3 cases of diaphragmatic hernia after liver transplant and discuss the possible contributing factors.Diaphragmatic hernia should nevertheless be added to the list of potential complications after liver transplant in the pediatric population. Pediatric transplant physicians and surgeons should be aware of this complication so that it is recognized promptly in both acute and nonacute settings and appropriate action is taken.

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Untitled

Kırnap

Akdur²,

Özçay³

et al. 2015

Exp Clin Transplant

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“…The complication has not been reported after left lobe liver donation, but has been seen in left lobe liver recipients. 7,8 Associated risk factors for complications and herniation in the liver recipient may include such concerns as malnutrition, weight loss, resistance, and ability to heal after surgical intervention. Neither of these 2 patients had these problems preoperatively.…”

Section: Discussionmentioning

confidence: 99%

Incarcerated Diaphragmatic Hernia With Intrathoracic Bowel Obstruction After Right Liver Donation

Dieter

Spitz

Kuzycz

2011

International Surgery

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Liver transplantation has become an acceptable surgical procedure with the advancement of the technical and rejection considerations involved. Initially nonliving donors were used for transplantation procedures. However, with improved techniques, living donor procedures have become much more frequent. With this, complications involving the transplant organ donor may occur. We present 2 patients with intrathoracic bowel obstruction due to herniation of the small intestine and colon through a defect in the dome of the diaphragm with development of chest pain and gastrointestinal symptoms. Both patients were diagnosed by computerized tomography scan and had a right thoracotomy with lysis of the adhesions, reduction of the hernia, repair of the diaphragm, and mesh reinforcement of the diaphragm. Neither patient had a prior diaphragm defect. These patients, on review of the literature, represent the first 2 such reported cases and suggest the need to be aware of any potential diaphragm defects before closure of the abdomen after resection of the donor liver or if they develop appropriate symptomatology.

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“…4 A diaphragmatic hernia is a relatively common complication following liver transplantation in small children. 11 The risk factors for this complication seem to be low body weight and oversized liver grafts. In addition, the liver graft is often placed at a more medial position.…”

Section: Discussionmentioning

confidence: 99%

Gangrenous intrathoracic appendicitis, a rare cause of right-sided chest pain: Report of a case

et al. 2010

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Diaphragmatic hernias are becoming increasingly common due to radiofrequency ablation of malignant liver tumors. Most patients eventually present with symptoms caused by bowel obstruction. A 54-year-old woman with pleuritic pain and fever had a right-sided enterothorax probably caused by hemihepatectomy several years before. The patient was diagnosed with perforated gangrenous intrathoracic appendicitis during an emergency laparotomy for suspected incarceration of her diaphragmatic hernia. She was treated with an appendectomy and suturing of her right hemidiaphragm. An acquired diaphragmatic hernia should therefore be surgically repaired as soon as it is diagnosed in order to avoid complications.

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Right-sided diaphragmatic hernia in infants after liver transplantation

Cited by 35 publications

References 16 publications

Untitled

Untitled

Incarcerated Diaphragmatic Hernia With Intrathoracic Bowel Obstruction After Right Liver Donation

Gangrenous intrathoracic appendicitis, a rare cause of right-sided chest pain: Report of a case

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