Gupta Anupam K, Pansari Mridul, Yi Slee, Genuit Thomas, Rodriguez Ariel
Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, USA.
Surgery, Florida Atlantic University, Boca Raton, USA.
Cureus. 2020 Apr 16;12(4):e7689. doi: 10.7759/cureus.7689.
Transdiaphragmatic hernia via the central tendon in the pericardium is a rare entity. Most often, these hernias are acquired and related to the iatrogenic creation of a transdiaphragmatic-pericardial defect. We would like to present a case of a 62-year-old male who presented with acute chest pain and was diagnosed to have a transdiaphragmatic-pericardial hernia on computed tomography. He has a history of cardiac intervention via an abdominal approach 12 years earlier. A segment of jejunum was found strangulated in the defect. We used DaVinci Xi® (Intuitive Surgical, Sunnyvale, CA) robot and were able to successfully reduce the hernia, repair the defect, and resect a short segment of jejunum which was non-viable. The utilization of a minimally invasive approach may be feasible, and the use of a robotic surgical system may enhance the surgeon's ability to repair the defect.
经心包中央腱的经膈疝是一种罕见的病症。这些疝大多是后天获得性的，与经膈心包缺损的医源性形成有关。我们想介绍一例62岁男性患者，他因急性胸痛就诊，计算机断层扫描诊断为经膈心包疝。他12年前有经腹部途径进行心脏介入治疗的病史。在缺损处发现一段空肠绞窄。我们使用达芬奇Xi®（直观外科公司，加利福尼亚州桑尼维尔）机器人，成功地还纳了疝，修复了缺损，并切除了一小段无活力的空肠。采用微创方法可能是可行的，使用机器人手术系统可能会提高外科医生修复缺损的能力。
