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

Many patients with illnesses that once were fatal at birth or during childhood now survive into adult life. This article considers four respiratory illnesses of early life in which long-term survival now occurs frequently: cystic fibrosis, diaphragmatic hernia, esophageal atresia-tracheoesophageal fistula, and bronchopulmonary dysplasia. In cystic fibrosis, although the median age at death is now 25 years, chronic pulmonary infection due ultimately to the abnormal composition and clearance of airway mucus is still the usual cause of death. Earlier survivors of congenital diaphragmatic hernia had only minor diminution of perfusion and ventilation of the lung on the side of the hernia as adolescents or young adults; however, as infants with greater degrees of pulmonary hypoplasia have successful repair of their hernias, more long-term respiratory impairment will probably be found. The esophageal atresia tracheoesophageal fistula complex leaves all esophagi and many tracheas permanently abnormal; recurrent aspiration, repeated pneumonia, and an unduly collapsible trachea are the result, although symptoms may be few. Survivors of bronchopulmonary dysplasia have decreased exercise capacity, wheezing, and recurrent pneumonia, although their chest radiographs may become normal or almost normal.
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PMID:Caldwell Lecture. Respiratory problems of early life now allowing survival into adulthood: concepts for radiologists. 835 26

Pulmonary sequestration is a complex anomaly involving the pulmonary parenchyma and its vascularity. From 1975 to 1992, 10 cases have been treated at the UCLA Medical Center. The ages of the seven females and three males were bimodal, the median age of the seven children was 29 days (range 1 day-6 years); it was 32 years (range 28-39) for the three adults. One child was delivered by cesarean section for fetal distress and another was born at 29 weeks gestation. Symptoms included: recurrent pneumonia (5), respiratory distress (5), hemoptysis (2), stridor (1), and pleuritis (1). Chest radiographs were consistent with sequestration in seven patients and diaphragmatic hernia in another, but incorrectly diagnosed one diaphragmatic eventration and one pulmonary varix. Computed tomographs suggested sequestration in five patients, but mistakenly interpreted a pulmonary varix in one case. Angiography, ultrasonography, and magnetic resonance imaging were infrequent investigative studies and yielded variable results. All patients underwent thoracotomy and lobectomy without morbidity or mortality. Five had intralobar and five had extralobar sequestration. All adults had intralobar sequestration. Two had aberrant subdiaphragmatic arterial vessels. Eight had vessels originating from the descending thoracic aorta. Nine patients are asymptomatic at six months to 10 years follow up. The 29-week-old premature infant died 30 days postoperatively due to necrotizing enterocolitis. Pulmonary sequestration remains an uncommon entity. The radiologic investigations that provide the most information are the chest radiography and computed tomography. Definitive diagnosis is made at thoracotomy. Pulmonary sequestrations are resected with excellent results by the trained thoracic surgeon who is aware of the unusual vascular connections.
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PMID:Pulmonary sequestration: 17-year experience at UCLA. 825 32

During a 13-month period, 13 patients with asplenia syndrome were evaluated with MRI for cardiovascular and visceral anomalies. The MR images were reviewed for the presence of haitus hernia which was found in three patients. One of the remaining ten patients with no MRI evidence of hiatus hernia was diagnosed as having gastro-oesophageal reflux and hiatus hernia by an oesophagogram and 24-h pH monitoring. This patient had undergone fundoplication prior to MRI. Out of the 13 patients (31%) with asplenia syndrome, 4 had hiatus hernia. It appears that among patients with the asplenia syndrome, hiatus hernia is a frequent finding. Recurrent pneumonia or bronchiolitis in patients with asplenia syndrome requires evaluation for the presence of hiatus hernia and gastro-oesophageal reflux.
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PMID:Association of hiatus hernia with asplenia syndrome. 831 9

At chest radiography performed for recurrent pneumonia in a 3-month-old boy, an air-fluid level in the right cardiophrenic angle was found and initially perceived as a lung abscess. Upper gastrointestinal tract radiographs, however, revealed a congenital diaphragmatic hernia, which was successfully repaired.
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PMID:Right-sided hiatal hernia of the oesophagus. 1009 61

Down syndrome patients are immunodeficient and commonly suffer from respiratory infections. Two children with Down syndrome were referred for evaluation of recurrent pneumonia accompanied by persistent infiltrate on chest radiographs. In both cases the radiographic abnormalities were actually found to be Morgagni hernia. When a child with Down syndrome has a persistent lower lobe infiltrate on chest radiograph, the possibility of a diaphragmatic defect should be entertained.
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PMID:Morgagni hernia mimicking pneumonia in Down syndrome. 1784 58

Morgagni hernia association with Bochdalek diaphragmatic hernia is a very rare congenital anomaly. The authors reported a 2-year-and-2-month-old boy with Down syndrome who has a history of recurrent pneumonia over a one-year period. A chest film of the first admission at 6 months of age revealed only minimal pulmonary infiltration and normal findings of both sides of the diaphragm. The last investigations with chest films and CT scan were suggestive of sequestration of the right lung with left Morgagni and left Bochdalek diaphragmatic hernias. An exploratory laparotomy revealed bilateral Morgagni and left Bochdalek hernias with hernial sacs in all of the diaphragmatic defects. All of the hernial sacs were excised and the diaphragmatic defects were closed with 2-0 silk interruptedly. Postoperative course was uneventful and he was doing well during his follow-up at one year.
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PMID:Bilateral Morgagni hernias association with left Bochdalek diaphragmatic hernia: a very rare anomaly. 1925 13

Pulmonary sequestrations (PS) are rare congenital malformations that can be difficult to diagnose. PS have no connection with the bronchial tree and are vascularized through an aberrant artery mostly arising from descending thoracic or abdominal aorta. The standard diagnostic method is the computed tomography angiography and delayed diagnosis can lead to recurrent pneumonia and hemoptysis. Herein, we have a case of a patient with an intralobar sequestration associated with a Bochdalek hernia. The diagnosis was delayed in this case as with many other similar case reports because details of the patient's history were overlooked.
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PMID:Intralobar pulmonary sequestration associated with Bochdalek hernia: first reported case in an adult male and literature review. 3013 7

Morgagni hernia is the rarest form of congenital diaphragmatic hernia and is commonly found either in the first few hours of life or in the antenatal period. It is less common in adults and is mostly diagnosed accidentally in asymptomatic patients. Symptomatic adult cases are even rarer with a wide variety of symptoms. We report a patient with a 1-year history of chronic recurrent cough and dyspnea who had been misdiagnosed with recurrent pneumonia before being recognized and treated for Morgagni hernia.
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PMID:A rare adult morgagni hernia mimicking lobar pneumonia. 3024 82