Kim Yi-Suk, Lee In Sun, Jung Go-Un, Kim Myeung Ju, Oh Chang Seok, Yoo Dong Su, Lee Won-Joon, Lee Eunju, Cha Soon Chul, Shin Dong Hoon
Department of Anatomy, Ewha Womans University School of Medicine, Seoul, Korea.
Department of Radiology, Seoul National University Hospital, Bundang, Korea.
PLoS One. 2014 Jul 2;9(7):e99779. doi: 10.1371/journal.pone.0099779. eCollection 2014.
Congenital diaphragmatic hernia (CDH) is a birth defect of the diaphragm resulting in pulmonary sequelae that threaten the lives of infants. In computed tomography (CT) images of a 17th century middle-aged male mummy (the Andong mummy), we observed that the abdominal contents had protruded into the right thoracic cavity through the diaphragmatic defect, accompanied by a mediastinal shift to the left. On autopsy, the defect in the right posterolateral aspect of the diaphragm was reconfirmed, as was the herniation of the abdominal organs. The herniated contents included the right lobe of the liver, the pyloric part of the stomach, a part of the greater omentum, and the right colic flexure connecting the superior part of the ascending colon and the right part of the transverse colon. Taking our CT and autopsy results together, this case was diagnosed as the Bochdalek-type CDH. Herein we make the first ever report of a CT-assisted diagnosis of a pre-modern historical case of CDH. Our results show the promising utility of this modality in investigations of mummified human remains archaeologically obtained.
先天性膈疝(CDH)是一种膈肌先天性缺陷,会导致肺部后遗症,威胁婴儿生命。在一具17世纪中年男性木乃伊(安东木乃伊)的计算机断层扫描(CT)图像中,我们观察到腹腔内容物通过膈肌缺损突入右胸腔,并伴有纵隔向左移位。尸检时,再次证实了膈肌右后外侧的缺损以及腹部器官的疝出。疝出的内容物包括肝脏右叶、胃幽门部、大网膜一部分以及连接升结肠上部和横结肠右侧的右结肠曲。综合我们的CT和尸检结果,该病例被诊断为波氏孔型先天性膈疝。在此,我们首次报告了CT辅助诊断的一例近代以前历史病例的先天性膈疝。我们的结果表明,这种方法在考古发掘的人类木乃伊遗骸研究中具有广阔的应用前景。