Borselle Dominika, Międzybrodzki Krzysztof, Gerus Sylwester, Zaleska-Dorobisz Urszula, Hałoń Agnieszka, Szenborn Leszek, Patkowski Dariusz
Department of Pediatric Surgery and Urology, Wroclaw Medical University, 50-556 Wrocław, Poland.
Department of General and Pediatric Radiology, Wroclaw Medical University, 50-369 Wrocław, Poland.
Pediatr Rep. 2022 Mar 11;14(1):140-146. doi: 10.3390/pediatric14010020.
(1) Introduction: Recurrent diaphragmatic hernia is a relevant diagnostic and treatment dilemma. We have presented a patient with ingrowing liver as an atypical diaphragmatic hernia recurrence and discussed major aspects of diagnostic methods and the selection of an appropriate operative treatment. (2) Case description: We discuss a case of a patient with right-sided recurrent CDH (Congenital Diaphragmatic Hernia) who had primary thoracoscopic repair in newborn period. During infancy and early childhood, the patient presented recurrent upper and lower respiratory tract infections and bronchial hyperreactivity. The clinical picture was initially unclear. A CT scan was inconclusive to diagnose a recurrence. The patient was scheduled to have a re-thoracoscopy. A part of the liver was herniated into the pleural cavity. This fragment of 'ingrowing' liver was removed, and the diaphragmatic secondary defect was repaired. (3) Conclusions: This case proved that thoracoscopy can be a preferred technique in the diagnosis and treatment of CDH recurrence.
(1)引言:复发性膈疝是一个重要的诊断和治疗难题。我们报告了一例肝脏内陷作为非典型膈疝复发的病例,并讨论了诊断方法的主要方面以及合适手术治疗的选择。(2)病例描述:我们讨论了一例右侧复发性先天性膈疝患者的病例,该患者在新生儿期接受了初次胸腔镜修复术。在婴儿期和幼儿期,该患者反复出现上、下呼吸道感染和支气管高反应性。临床表现最初不明确。CT扫描对于诊断复发没有定论。该患者计划进行再次胸腔镜检查。发现一部分肝脏疝入胸腔。切除了这块“内陷”的肝脏,并修复了膈继发性缺损。(3)结论:该病例证明胸腔镜检查可以成为先天性膈疝复发诊断和治疗的首选技术。