Cain-Trivette Caitlin J, Robinson Newell Bryce, Kadenhe-Chiweshe Angela, Steigman Shaun, Spigland Nitsana A
Department of Surgery, The New York Hospital-Cornell Medical Center, 525 E 68th Street New York, NY 10065, United States.
Department of Pediatric Surgery, The New York Hospital-Cornell Medical Center, 525 E 68th Street New York, NY 10065, United States.
J Surg Case Rep. 2024 Sep 5;2024(9):rjae566. doi: 10.1093/jscr/rjae566. eCollection 2024 Sep.
Right sided congenital diaphragmatic hernia (CDH) associated with hepatopulmonary fusion (HPF) is a rare congenital anomaly in which the herniated liver is fused with lung parenchyma. We discuss the case of an infant with right-sided CDH and HPF found on index operation for repair of right-sided CDH. Due to the high incidence of vascular anomalies associated with HPF the decision was made to close the patient and get further imaging to characterize the HPF before returning to the operating room for definitive repair. We describe a novel and successful operative approach where the liver was left entirely fused to the lung and the liver was partially brought down from the chest and was plicated to the diaphragm form a seal between the parietal and pleural cavities to repair the CDH.
右侧先天性膈疝（CDH）合并肝肺融合（HPF）是一种罕见的先天性异常，其中疝入的肝脏与肺实质融合。我们讨论了一例在初次手术修复右侧CDH时发现右侧CDH合并HPF的婴儿病例。由于与HPF相关的血管异常发生率较高，决定关闭患者并进行进一步成像以明确HPF的特征，然后再返回手术室进行确定性修复。我们描述了一种新颖且成功的手术方法，即让肝脏完全与肺融合，将肝脏部分从胸腔下拉并折叠到膈肌上，在壁层和胸膜腔之间形成密封以修复CDH。
