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

We report six cases of Morgagni hernia diagnosed and operated on in our pediatric surgical unit during a 14-year period. Four children were younger than 1 year and two between 1 and 2 years. Predominance in males was found. Associated congenital pathology was present in 3 children (Down's syndrome, diaphragmatic relaxation, criptorquidia and pyelo-ureteral stenosis). Predominant clinical features were respiratory infections and vomiting. In only one patient clinical onset was with respiratory distress. Plain chest x-ray was the most used diagnostic procedure. In all cases barium enema was performed to confirm the clinical diagnosis. Most frequent surgical approach was a midline supra-umbilical laparotomy. Diaphragmatic defect was left sided in 3 children and right-sided in the other 3. Transverse colon and liver were the most frequent herniated viscera. Postoperative follow-up showed no complications or recidives.
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PMID:[Morgagni hernia in childhood]. 848 9

Left paraduodenal hernias are a rare cause of abdominal pain or obstruction. However, because there is high associated mortality (20 %), prompt and accurate diagnosis is essential. Because internal hernias are not detectable on physical examination, imaging is relied upon for pre-operative diagnosis. Although both computed tomography and barium studies demonstrate left paraduodenal hernias as a cluster of bowel located posterior to the stomach and to the left of the distal duodenum with absence of the normal interdigitation between loops, the findings may be subtle. Knowledge of these findings can avoid an unnecessary delay in diagnosis. We present the case of a 15-year-old girl with a left paraduodenal hernia, where initial CT and barium studies demonstrated nonobstructed jejunum within the hernia sac. Two weeks later a repeat study showed obstructed distal ileum, rather than proximal jejunum, within the sac.
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PMID:Left paraduodenal hernia leading to ileal obstruction. 875 66

This work was aimed at investigating the CT anatomy in patients submitted to Nissen's fundoplication. Forty patients (mean age: 61 years) with peptic esophagitis (9 patients), refractory gastroesophageal (GE) reflux (11 patients) and hiatal hernia (20 patients) were examined. CT studies were performed with a third generation unit (CT Pace, General Electric, USA) with the patients in the prone position, after Gastrovison (Schering) and barium paste administration. In 34 patients, CT demonstrated surgery-related anatomical changes, such as the presence of a soft tissue mass at the distal third of the esophagus. In 4 patients, functional incompetence of the fundoplication (3 patients) and a recurrent hyatal hernia (1 patient) were demonstrated. In conclusion, CT studies performed with a dedicated technique permitted the accurate assessment of the anatomy of the GE junction after Nissen's fundoplication. In our study, CT demonstrated the presence of postoperative fluid collections and specific signs related to fundoplication incompetence. Our results suggest a possible application of CT to the postoperative follow-up of the patients submitted to Nissen's fundoplication, with a complementary role that of to endoscopy and functional exams.
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PMID:[Computed tomography patterns in patients treated with laparoscopic Nissen fundoplication for gastroesophageal reflux]. 883 Mar 61

A periodic examination of chest-X-ray films showed abnormal elevation of the right diaphragm in a 39-year-old man, who had a history of right cordal contusion due to fall from a bridge one and a half years ago. The patient had no clinical symptoms after the accident. Chest and abdominal CT scans and barium examinations of gastro-intestinal tract revealed herniation of the omentum, colon and liver into the right thoracic cavity. Under the diagnosis of diaphragmatic hernia, the patient underwent an operation through a thoracoabdominal approach showing prolapse of the omentum, colon, gall bladder and a part of liver into the thoracic cavity. Prolapse of a gallbladder is rare. Further examinations are necessary with this lesion in mind when physicians find an abnormal shadow of the diaphragm.
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PMID:[Right traumatic diaphragmatic hernia: a case report]. 884 56

Case 1, a 9-year-old woman, was admitted to our hospital because of nausea, vomiting, and epigastralgia. Diagnosis of Bochdalek hernia was made by the unusual course of naso-gastric tube. At surgery through the left posterorateral thoracotomy, the herniation of the stomach, small intestine, and colon to the thoracic cavity through the dorsolateral defect of the diaphragm were revealed. Case 2, a 35-year-old man, was admitted to our hospital because of dyspnea. Similar diagnosis was made by the examination of upper G1 series and barium enema, which demonstrated the presence of multiple loops of the small intestine and colon in the left thoracic cavity. Their postoperative courses were uneventful. Most of Bochdalek hernia is observed in infancy, and adolescent or adult case is is rarely reported (approximately 10% of all cases). Since this often misdiagnosed as pleuritis or pulmonary tuberculosis, a cautious examination is necessary for the establishment of the correct diagnosis.
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PMID:[Two cases of the congenital posterolateral diaphragmatic hernia were reported]. 899 51

A 30-year-old man was admitted to the hospital 7 years after an automobile accident during which a lumbar vertebra was fractured. Immediately after the accident he had neither thoracic nor abdominal symptoms. An X-ray film obtained 4 years after the accident showed elevation of the left side of the diaphragm. That elevation progressed over the next 3 years, although the patient had no symptoms. On admission, a chest X-ray film showed blunting of the left costo-phrenic angle and mobility of the shadow, which simulated a pleural effusion. A chest CT scan and barium studies showed that portions of the small intestine, transverse colon and descending colon were in the left side of the thorax, but the diaphragm was not seen. The patient was given a diagnosis of delayed traumatic diaphragmatic hernia after T1-weighted sagittsal magentic resonance images revealed the whole diaphragm and the hernial orifice. Magnetic resonance imaging can be very useful in the evaluation of diaphragmatic hernia.
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PMID:[Delayed traumatic hernia diagnosed with magnetic resonance imaging]. 907 Nov 69

Acute gastric volvulus in infancy is a rare disorder and a surgical emergency. Prompt clinical suspicion and radiological assessment are essential for this life-threatening condition. We report a 3-month-old female case, admitted for an initial suspicion of an intestinal obstruction. She presented unproductive retching, respiratory distress, epigastric distension and lethargy. It was not possible to introduce a naso-gastric tube. A radiological contrast study showed an occluded cardio-esophageal junction without passage of barium, two gastric fluid levels and a horizontally positioned stomach occupying the inferior portion of the left hemithorax, suggesting a left diaphragmatic hernia. Laparotomy revealed an acute mesenterico-axial gastric volvulus with a left posterolateral diaphragmatic hernia. The stomach volvulus was untwisted, the diaphragmatic defect was repaired after reduction of the herniated contents and no gastropexy was done. At 3 and 6-months follow-up examination the infant was asymptomatic and thriving.
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PMID:Acute gastric volvulus and congenital posterolateral diaphragmatic hernia. 916 58

We report our recent experience with an asymptomatic case of Morgagni hernia composed of hypertrophic adipose tissue in the falciform ligament. The patient was a 47-year-old obese para-II woman. A chest X-ray during a routine health checkup showed an abnormal shadow in the right cardiophrenic angle that was larger than one year previously. Computed tomograms revealed a fat-density mass in the right side of the chest in contact with the anterior chest wall, pericardium and sternum that continued into the abdominal cavity. Magnetic resonance imaging (MRI) showed that the intrathoracic mass lesion was continuous with the subphrenic tissue, and that the hilus of the hernia was 5 x 3 cm in size. A barium gastro-intestinal series revealed no abnormal findings. Surgical repair was achieved through the transabdominal approach. The omentum was found in its normal position. The herniated adipose tissue in the falciform ligament was repositioned on the peritoneal side, and excised. The hilus of the hernia was then closed with knotted sutures. Postoperatively, the abnormal shadow on the X-ray was no longer present, and the postoperative course was uneventful. Histological examination revealed the hernia to consist of mature adipose tissue 5 x 10 x 3 cm in size. This is the first case of Morgagni hernia composed of hypertrophic adipose tissue in the falciform ligament reported in Japan.
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PMID:[A case of Morgagni hernia composed of hypertrophic adipose tissue in the falciform ligament]. 917 Aug 76

Meckel's diverticulum (Md) is the most common congenital anomaly of the gastrointestinal tract. It results from an incomplete obliteration of the omphalomesenteric duct during fetal life. It is frequently located on the antimesenteric border of the ileum at 80 cm from the ileum-cecal valve. It contains heterotopic mucosa in 30% of the cases and in 70% of these the mucosa is of the gastric type. The most common complication in childhood is represented by hemorrhage. Preoperative diagnosis is often difficult. Barium enema, Tc-99 scintigraphy and selective mesenteric angiography usually can permit diagnosis. In adults occlusion, perforation, diverticulum infection, Littre's hernia and tumors represent the complications of Meckel's diverticulum. A case of Md is reported because of the unusual clinical presentation.
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PMID:[Unusual clinical presentation of Meckel's diverticulum. A case report]. 923 58

A 38-year-old female was admitted to Shonai Hospital with severe abdominal pain and nausea after playing at a tug of war in the athletic meeting. The X-ray film showed air above the left diaphragm, and CT scan and barium enema revealed the incarcerated transverse colon to the left thoracic cavity. Operation was performed through a thoracotomy. Because of no evidence of trauma, the case was diagnosed as adult Bochdalek hernia. Repair could be done by direct suture and her postoperative course was uneventful.
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PMID:[Adult bochdalek hernia after playing at a tug of war]. 933 May 23


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