Pillai Sastha Ahanatha, Chinnappan Santhanakrishnan
Department of Surgical Gastroenterology, Government Mohan Kumaramangalam Medical College Hospital, Salem, Tamilnadu India ; Surakksha Multispecialty Hospital, 264/148, Cherry Road, Near Mulluvadi Gate, Salem, 636001 India.
Department of Anaesthesiology, Government Mohan Kumaramangalam Medical College Hospital, Salem, Tamilnadu India ; Surakksha Multispecialty Hospital, 264/148, Cherry Road, Near Mulluvadi Gate, Salem, 636001 India.
Indian J Surg. 2016 Jun;78(3):238-40. doi: 10.1007/s12262-015-1400-y. Epub 2015 Nov 13.
Patients with congenital diaphragmatic hernias (CDH) usually present in the neonatal period with respiratory distress. Delayed presentation of CDH in adults is rare and difficult to diagnose. We present a 42-year-old female patient who came with complaints of epigastric pain and breathlessness on exertion. X-ray and CT scan of the chest revealed a right-sided Morgagni hernia. The contents of the hernia were reduced and a primary tension free repair of the hernia defect was done through laparotomy. The postoperative course was uneventful. A strong clinical suspicion and good interpretation of radiological images help diagnose CDH which present late. Prompt surgical repair is mandatory and the outcomes are usually favorable. Primary repair is usually successful; however, mesh repair may be required for larger defects.
先天性膈疝(CDH)患者通常在新生儿期出现呼吸窘迫症状。成人CDH延迟表现罕见且难以诊断。我们报告一名42岁女性患者,她因上腹部疼痛和劳力性呼吸困难前来就诊。胸部X线和CT扫描显示右侧莫尔加尼疝。将疝内容物还纳,并通过剖腹手术对疝缺损进行了一期无张力修补。术后过程顺利。强烈的临床怀疑和对影像学图像的良好解读有助于诊断迟发性CDH。必须及时进行手术修补,且结果通常良好。一期修补通常成功;然而,对于较大的缺损可能需要使用补片修补。