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Right congenital diaphragmatic hernia associated with abnormality of the liver in adult.

Abstract A Bochdalek hernia (BH) occurs when abdominal contents herniate through the postero-lateral segment of the diaphragm. The right side is affected considerably less commonly than the left. Most BHs present are diagnosed early in life, with some element of cardio-respiratory distress. Rarely, hernias that remain clinically silent until adulthood when they present as life-threatening surgical emergencies. We report a case 35 year old female who emergency exploratory laparotomy for a complete mechanical bowel obstruction. At surgery the redundant transverse colon was twisted and incarcerated within the right hemithorax, creating a closed loop obstruction. The right colon, appendix, terminal ilium, and three accessories right liver lobes were also dragged into the right thoracic cavity. After reducing the hernia, the diaphragmatic defect was primarily repaired with non-absorbable suture. The redundant transvers colon which had been compromised was resected and primary end-to- end anastomosis was carried out. Incidental appendectomy was done. The patient was sent into ICU for post-operative monitoring. She made an uneventful recovery and remains asymptomatic at nine month follow-up. I discuss what i believe to be the first case report of complicated right diaphragmatic hernia in Botswana, associated with another congenital mal-formation (accessories hepatic lobes, partial mal-rotation, and redundant transvers colon) in adult.
PMID
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Authors

Mayor MeshTerms
Keywords

Bochdalek hernia (BH)

appendectomy

colon

congenital

hernia repair

Journal Title the pan african medical journal
Publication Year Start




PMID- 29255540
OWN - NLM
STAT- MEDLINE
DCOM- 20171222
LR  - 20171222
IS  - 1937-8688 (Electronic)
VI  - 28
DP  - 2017
TI  - Right congenital diaphragmatic hernia associated with abnormality of the liver in
      adult.
PG  - 70
LID - 10.11604/pamj.2017.28.70.11249 [doi]
AB  - A Bochdalek hernia (BH) occurs when abdominal contents herniate through the
      postero-lateral segment of the diaphragm. The right side is affected considerably
      less commonly than the left. Most BHs present are diagnosed early in life, with
      some element of cardio-respiratory distress. Rarely, hernias that remain
      clinically silent until adulthood when they present as life-threatening surgical 
      emergencies. We report a case 35 year old female who emergency exploratory
      laparotomy for a complete mechanical bowel obstruction. At surgery the redundant 
      transverse colon was twisted and incarcerated within the right hemithorax,
      creating a closed loop obstruction. The right colon, appendix, terminal ilium,
      and three accessories right liver lobes were also dragged into the right thoracic
      cavity. After reducing the hernia, the diaphragmatic defect was primarily
      repaired with non-absorbable suture. The redundant transvers colon which had been
      compromised was resected and primary end-to- end anastomosis was carried out.
      Incidental appendectomy was done. The patient was sent into ICU for
      post-operative monitoring. She made an uneventful recovery and remains
      asymptomatic at nine month follow-up. I discuss what i believe to be the first
      case report of complicated right diaphragmatic hernia in Botswana, associated
      with another congenital mal-formation (accessories hepatic lobes, partial
      mal-rotation, and redundant transvers colon) in adult.
FAU - Ayane, Gezahen Negusse
AU  - Ayane GN
AD  - University of Botswana, Faculty of Medicine, Botwana.
FAU - Walsh, Mikel
AU  - Walsh M
AD  - University of Botswana, Faculty of Medicine, Botwana.
FAU - Shifa, Jemal
AU  - Shifa J
AD  - University of Botswana, Faculty of Medicine, Botwana.
FAU - Khutsafalo, Kadimo
AU  - Khutsafalo K
AD  - University of Botswana, Faculty of Medicine, Botwana.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20170922
PL  - Uganda
TA  - Pan Afr Med J
JT  - The Pan African medical journal
JID - 101517926
SB  - IM
MH  - Adult
MH  - Appendectomy/methods
MH  - Botswana
MH  - Colon, Transverse/abnormalities
MH  - Female
MH  - Follow-Up Studies
MH  - Hernias, Diaphragmatic, Congenital/complications/*diagnosis
MH  - Humans
MH  - Intestinal Obstruction/*etiology/surgery
MH  - Laparotomy/methods
MH  - Liver/*abnormalities
PMC - PMC5724727
OTO - NOTNLM
OT  - Bochdalek hernia (BH)
OT  - appendectomy
OT  - colon
OT  - congenital
OT  - hernia repair
EDAT- 2017/12/20 06:00
MHDA- 2017/12/23 06:00
CRDT- 2017/12/20 06:00
PHST- 2016/11/23 00:00 [received]
PHST- 2017/07/28 00:00 [accepted]
PHST- 2017/12/20 06:00 [entrez]
PHST- 2017/12/20 06:00 [pubmed]
PHST- 2017/12/23 06:00 [medline]
AID - 10.11604/pamj.2017.28.70.11249 [doi]
AID - PAMJ-28-70 [pii]
PST - epublish
SO  - Pan Afr Med J. 2017 Sep 22;28:70. doi: 10.11604/pamj.2017.28.70.11249.
      eCollection 2017.