Ultrasound evaluation of right diaphragmatic eventration and hernia

Karmazyn, Boaz; Shold, Andrew J.; Delaney, Lisa R.; Brown, Brandon P.; Marine, Megan B.; Jennings, S. Gregory; Gray, Brian W.

doi:10.1007/s00247-019-04417-1

Cited by 13 publications

(15 citation statements)

References 18 publications

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“…In our study, none of the fetuses had pleural or pericardial effusion, and hence, this finding could not be utilized in the diagnosis. Karmazyn et al [24] have shown that presence of a folding free muscle edge and narrow angle waist favored diagnosis of CDH over CDE in postnatal period although this differentiation was not possible in around one-third of their cases. The findings of their study cannot be directly compared with our study because they had evaluated diaphragmatic defects in infants after birth and not in prenatal period.…”

Section: Discussionmentioning

confidence: 98%

Fetal magnetic resonance imaging in the evaluation of congenital diaphragmatic anomalies

Mahalingam

Babu

Rangasami

et al. 2020

Egypt J Radiol Nucl Med

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Background Congenital abnormalities of the diaphragm cause impairment of lung development and are an important cause of post-natal morbidity and mortality. Congenital diaphragmatic eventration (CDE), a less sinister diaphragmatic anomaly compared to the more common congenital diaphragmatic hernia (CDH), often tends to mimic CDH on prenatal imaging. This study evaluates the role of fetal magnetic resonance imaging (MRI) in differentiating these two entities. Results This was a retrospective study which included fetal MRI studies done in patients with ultrasound diagnosis of fetal diaphragmatic anomaly. MRI exam was performed with a 1.5 T superconducting system with eight-element torso array coil. The images were studied by two radiologists experienced in fetal imaging in consensus. Diagnosis of CDE was made if the dome of the diaphragm was visualized as a thin hypointense line separating the lung from abdominal structures on coronal and sagittal MRI sequences. If this thin hypointense line was not visualized, a diagnosis of CDH was made. The findings were then correlated with autopsy/intra-operative findings/post-natal imaging follow-up. A total of 12 patients were included in the study. In these 12 patients, 13 diaphragmatic abnormalities were diagnosed on MRI (1 fetus had bilateral diaphragmatic anomaly). Of the 13 diaphragmatic anomalies detected, 7 (54%) were CDH and 6 (46%) were CDE. The type of diaphragmatic anomaly was correctly identified on MRI in all except one fetus in which CDE was misdiagnosed as CDH. The Fisher exact test statistic value was 0.0047. The result was significant at p < 0.01. Conclusion Fetal MRI is a useful tool for assessing congenital diaphragmatic anomalies. Visualization of the diaphragm on coronal and sagittal images helps in diagnosis of complete CDE and differentiating it from the more sinister CDH.

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Section: Discussionmentioning

confidence: 98%

Fetal magnetic resonance imaging in the evaluation of congenital diaphragmatic anomalies

Mahalingam

Babu

Rangasami

et al. 2020

Egypt J Radiol Nucl Med

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“…The reported incidence in adult population was estimated to be approximately 0.17% [2]. The patient frequently presents with subtle symptoms upon displacement of abdominal contents into the thoracic cavity, which requires thoughtful analysis and makes the diagnosis more challenging [1,2]. This case report emphasizes the findings from radiological modalities that can be used to diagnose a late-presentation CDH in adults.…”

Section: Introductionmentioning

confidence: 86%

“…It is undeniably rare and difficult to diagnose congenital diaphragmatic hernia in adults [1]. The reported incidence in adult population was estimated to be approximately 0.17% [2]. The patient frequently presents with subtle symptoms upon displacement of abdominal contents into the thoracic cavity, which requires thoughtful analysis and makes the diagnosis more challenging [1,2].…”

Section: Introductionmentioning

confidence: 99%

Massive pleural effusion post-emergency cesarean in undiagnosed congenital diaphragmatic hernia

Roslan

Nikkie

Wahab

2023

Int J Case Rep Images

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Introduction: Bochdalek’s hernia is a congenital diaphragmatic hernia (CDH) resulting from inadequate closure of the membrane over the left side of the hemidiaphragm. Patients will start to develop symptoms upon displacement of abdominal contents into the thoracic cavity. This case report highlights the radiological modality findings that can be used in diagnosing a late-presentation CDH in adults. Case Report: A 35-year-old postpartum woman developed shortness of breath, left-sided chest pain, episodes of vomiting and epigastric tenderness within 24 hours post-emergency cesarean section. An initial diagnosis of left tension hydrothorax was made based on the clinical and radiological findings. Left diagnostic and therapeutic thoracocentesis using landmark technique was performed and brownish fluid was obtained upon aspiration. Post-procedural chest X-ray (CXR) reported cystic-like features over the left hemithorax. Therefore, computed tomography (CT) thorax was proceeded and confirmed the left diaphragmatic hernia with a mediastinal shift to the right. However, the patient’s condition worsened and required emergency open thoracotomy with left diaphragmatic hernia repair. Intraoperative findings showed left Bochdalek’s hernia complicated by multiple visceral organ perforations secondary to previous thoracocentesis. The patient was discharged well after a few weeks of hospital stays. Conclusion: The diagnosis of late-presentation Bochdalek’s diaphragmatic hernia remained challenging and can be easily missed. Therefore, a comprehensive evaluation is required prior to performing an invasive diagnostic procedure. Chest X-ray and ultrasound are useful diagnostic aid in the absence of CT thorax and magnetic resonance imaging (MRI) modalities.

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La hernia de Morgagni (HM) fue descrita por primera vez por Giovanni Morgagni en 1761. [1][2][3] Es un defecto congénito poco frecuente, 1,4-6 con una incidencia de 1:2,500-5,000 nacidos vivos y comprende de 3-5% de todas las hernias diafragmáticas congénitas, 2,3 con una alta mortalidad neonatal aproximadamente de 10-30%. 7,8 LA HM se desarrolla debido a una fusión o desarrollo deficiente del diafragma y los arcos costales, 2 y Síndrome de Down y hernia de Morgagni en lactante Down syndrome and Morgagni hernia in infant

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“…9 El diagnóstico se puede realizar prenatalmente por ultrasonido o resonancia magnética; sin embargo, www.medigraphic.org.mx de 20-30% se detectan por primera vez después del nacimiento. 1,10 El principal estudio diagnóstico es la radiografía de tórax, 3 pero también son de utilidad las Rx de abdomen, y la tomografía axial computarizada de tórax. 4,6 Dentro de los diagnósticos diferenciales se incluyen a atelectasias, derrame pleural, y parálisis diafragmática.…”

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