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两种先天性病变的故事:一例先天性膈疝合并先天性心脏病成功手术治疗的病例报告及文献综述(本德 - 帕塔克疝)

A Tale of Two Congenital Lesions: A Case Report of Congenital Diaphragmatic Hernia and Congenital Heart Disease Managed by Successful Surgical Outcome With Review of the Literature (Bhende-Pathak Hernia).

作者信息

Bhende Vishal V, Bhatt Mahesh H, Patel Viral B, Tandon Rahul, Krishnakumar Mathangi

机构信息

Pediatric Cardiac Surgery, Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND.

Pediatric Interventional Cardiology, Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND.

出版信息

Cureus. 2024 Dec 6;16(12):e75238. doi: 10.7759/cureus.75238. eCollection 2024 Dec.

Abstract

Congenital diaphragmatic hernia (CDH) is a diaphragmatic defect that is usually situated on the left side in the posterolateral region, named a Bochdalek hernia (BH), which allows abdominal organs to herniate into the thoracic cavity. BH is a prevalently observed birth anomaly in infants but is rare in adults. Right-sided BH that involves the colon is exceptionally rare, and no prior cases have described ileocecal appendix involvement. Here, we present a case of a preschooler with a right-sided BH and patent ductus arteriosus (PDA), requiring distinct surgical approaches: left open thoracotomy for PDA ligation and right open thoracotomy for CDH repair. Surgical intervention is associated with reduced morbidity and mortality, favorable long-term outcomes, and a low recurrence rate, irrespective of the selected approach. Reinforcement through suture repair with mesh application, as well as PDA ligation, reinforced with metallic clips as the preferred surgical operation in this case. To the best of our knowledge, this is the first reported instance of a pediatric patient with right-sided BH that involves the appendix, alongside concurrent congenital heart disease (CHD). We propose the term Bhende-Pathak hernia for this pediatric variant.

摘要

先天性膈疝(CDH)是一种膈肌缺损,通常位于左侧后外侧区域,称为博赫dalek疝(BH),它使腹部器官疝入胸腔。BH是婴儿中普遍观察到的出生异常,但在成人中很少见。涉及结肠的右侧BH极为罕见,以前没有病例描述过回盲部阑尾受累情况。在此,我们报告一例患有右侧BH和动脉导管未闭(PDA)的学龄前儿童病例,需要采用不同的手术方法:左侧开胸手术结扎PDA,右侧开胸手术修复CDH。无论选择何种手术方法,手术干预都与降低发病率和死亡率、良好的长期预后以及低复发率相关。在本病例中,通过使用补片进行缝合修复加强,以及使用金属夹加强结扎PDA作为首选手术操作。据我们所知,这是首例报告的涉及阑尾的右侧BH同时合并先天性心脏病(CHD)的儿科患者。我们为此儿科变异型提出“Bhende-Pathak疝”这一术语。

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