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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Seventeen cases of different types of fetal thoracic and intrathoracic abnormalities were diagnosed prenatally by ultrasound: nonimmune hydrops (5 cases), diaphragmatic hernia (3), Potter's syndrome (3), chylothorax (1), exstrophy of the cloaca (1), the extreme form of prune-belly syndrome (2), cystic hygroma (1) and short rib polydactyly syndrome (Majevski type) (1 case). The ultrasonic features of nonimmune hydrops, diaphragmatic hernia, Potter's syndrome and cystic hygroma are well recognized by most experienced sonographers. The ultrasonic prenatal diagnosis of exstrophy of the cloaca, a very rare entity, has not been reported previously. The condition consists of a large infraumbilical anterior abdominal wall defect, lumbosacral myelomeningocele, and fetal ascites. The extreme form of prune-belly syndrome is associated with the absence of the abdominal wall musculature and marked dilatation of the urinary tract, presented ultrasonically as multiple large cysts occupying the distended fetal abdominal cavity. In exstrophy of the cloaca, prune-belly syndrome, Potter's syndrome and short rib polydactyly syndrome the chest abnormality is similar-extreme shortening of the thoracic cage, which has various causes. The differential diagnosis of all these entities and guidelines for their correct prenatal ultrasonic diagnosis are presented.
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PMID:Prenatal ultrasonic diagnosis of fetal thoracic and intrathoracic abnormalities. 352 48

Chylothorax after repair of congenital posterolateral diaphragmatic hernia has only been reported four times. We add a fifth case and have analyzed these five cases. In all five, the hernia was left sided and a sac was present that was excised. The chylothorax was always left sided. Chylous ascites did not occur. All cases responded to continuous chest drainage without surgical intervention on the thoracic duct or cysterna chyli. All five cases survived.
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PMID:Factors involved in chylothorax following repair of congenital posterolateral diaphragmatic hernia. 377 9

Between November 1986 and April 1993, 22 cases of intrathoracic abnormality were detected prenatally by ultrasound, and examined postnatally. There were 11 cases of diaphragmatic hernia, 5 cases of cystic adenomatoid malformation of lung, one case of chylothorax, two cases of lung sequestration, and three cases of bronchogenic cyst. The total number of deliveries during that period was 48,281 and the total number of major anomalies at that time was 669 (1.38%). Cases of hydrothorax of various etiology, as well as thoracic cage anomalies were excluded. Prenatal diagnosis allows planned delivery and the assembly of neonatologists and pediatric surgeons.
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PMID:A survey of non-cardiac fetal intrathoracic malformations diagnosed by ultrasound. 804 76

BACKGROUND. Post-operative chylous effusion is rare in infants. It may result from venous thrombosis, thoracic duct injury or lymphatic vessel obstruction. This paper describes 2 cases of diaphragm hernia with post-operative chylous effusion. CASE REPORTS Case 1: A newborn developed chylous ascites two weeks after repair of a left posterolateral diaphragm hernia. Abdominal paracentesis showed milky fluid containing numerous lymphocytes (98%). Ascites was rapidly reduced by feeding with medium-chain triglyceride-rich (MCT) formula. Case 2: A chylothorax was seen 7 days after surgery to repair a left posterolateral diaphragm hernia. Thoracocentesis showed serous fluid containing numerous lymphocytes (93%). The chylothorax was resolved after two thoracocenteses, parenteral nutrition and feeding with MCT formula. CONCLUSION. These cases are the third report of chylothorax and the second report of chylous ascites after surgical repair of a diaphragm hernia. The exact cause of the chylous effusion is not clear.
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PMID:[Chylous effusion and surgical treatment of diaphragmatic hernia in 2 newborn infants]. 806 Feb 9

Recent studies have suggested there may be a high incidence of pulmonary and extrapulmonary sequelae among infants who have undergone repair of congenital diaphragmatic hernia (CDH). The aim of this study was to identify factors that predict high-risk cases to facilitate counseling of parents. Morbidity, defined as conditions requiring treatment and/or hospitalization during follow-up, was documented. Only five of 15 cases that had been diagnosed antenatally (at 16 to 26 weeks' gestation) and underwent surgical repair after preoperative stabilization were without morbidity at the time of follow-up. Respiratory problems were identified in seven (chylothorax in 3, recurrent infections in 4) and failure to thrive in four; three infants required further gastrointestinal surgery. A comparison of infants with and without morbidity showed that the only significant difference between the groups was in the duration of respiratory support. A requirement for respiratory support for more than 10 days had 90% sensitivity, 100% specificity, and a positive predictive value for morbidity at follow-up of 100%.
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PMID:Prediction of morbidity during infancy after repair of congenital diaphragmatic hernia. 898 79

Chylothorax is a rarely recognised post-operative complication following repair of congenital diaphragmatic hernia. We report here a newborn infant with this condition which resolved with percutaneous chest drainage, total parenteral nutrition and enteral feeding of a formula high in medium-chain triglycerides.
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PMID:Chylothorax after repair of congenital diaphragmatic hernia--a case report. 1128 14

Chylothorax is a recognized cause of morbidity after repair of congenital diaphragmatic hernia (CDH). Management may include prolonged hospitalization with cessation of enteral feedings, repeated aspiration, chest tube drainage, total parenteral nutrition, and introduction of a medium chain triglyceride (MCT) diet as the effusion resolves. The authors report that the successful deployment of octreotide, a somatostatin analogue, hastened resolution of a postoperative chylothorax in a newborn infant with CDH.
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PMID:Octreotide for treatment of chylothorax after repair of congenital diaphragmatic hernia. 1289 19

In congenital diaphragmatic hernia (CDH), chest tube insertion at repair could determine rapid overexpansion of hypoplastic lungs, increasing the risk of pneumothorax. Therefore, in our institution no drainage tube at CDH repair was inserted after 1997. Afterwards several patients needed chest drainage for cardiopulmonary distress due to pleural effusion (PE) during the postoperative course. The aims of this study are to establish the incidence of PE requiring drainage for cardiopulmonary distress during postoperative course in CDH and to assess its eventual increase in patients with patch repair. Furthermore, the aetiology and treatment of PE are highlighted. Records of high-risk CDH operated on from 1998 to 2004 were reviewed. No chest tube was inserted at repair. Drainage was accomplished postoperatively if a cardiopulmonary distress due to PE occurred. Groups with and without patch were compared on gender, gestational age, birth weight, side of hernia, PE, hernial sac, central venous line and venous thrombosis, using the chi(2) and Student's t tests. Overall mortality rate was recorded. Out of 76 patients, 23 (30%) required patch repair. The PE occurred in 22 out of 76 patients, and in 68% of cases a chylothorax resulted. Birth weight was significantly lower, and the PE rate was significantly higher in patients with patch. Pleural drainage yielded improvement of ventilatory and respiratory parameters in all cases. Overall mortality rate was 16 and 23% in patients that required chest drain. The incidence of PE was 30% in CDH and significantly higher in patients with patch. The increased mortality rate in patients with PE causing cardiopulmonary distress warrants chest tube drainage before instability occurs.
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PMID:Pleural effusion requiring drainage in congenital diaphragmatic hernia: incidence, aetiology and treatment. 1677 Jun 3

A 2-year-old dog was presented with a 3-month history of increasing respiratory effort and rate, inappetence, and lethargy. Chest radiographs demonstrated significant pleural effusion, which was consistent with chyle on biochemical and cytological evaluations. Further diagnostic evaluation, including a thoracic computed tomographic scan, revealed a peritoneopericardial diaphragmatic hernia (PPDH) resulting in a large, fat-attenuating mass within the pericardium. The dog was taken to surgery for repair of the PPDH, pericardectomy, and cisterna chyli ablation. Rapid and permanent resolution of the chylothorax occurred postoperatively. This is the first reported case of chylothorax secondary to PPDH.
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PMID:Chylothorax associated with a congenital peritoneopericardial diaphragmatic hernia in a dog. 1941 49

The resection of oesophageal cancer offers the only chance of cure. The introduction of minimally invasive oesophagectomy has gained wide acceptance for the surgical treatment of oesophago-gastric cancers. The most commonly reported late complications of minimally invasive oesophagectomy are anastamotic stricture, chylothorax, chronic diarrhoea and delayed gastric emptying. Symptomatic hiatus hernia presenting as a late complication of laparoscopic cardio-oesophagectomy is not a widely reported complication. We have encountered three such cases, two of which were treated laparoscopically.
Hernia 2010 Apr
PMID:Hiatal hernias presenting as a late complication of laparoscopic-assisted cardio-oesophagectomy. 1959 Aug 16


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