Late recurrence of a congenital diaphragmatic hernia. Case report

Stephenson, B. M.; Stamatakis, J. D.

doi:10.1111/j.1471-0528.1991.tb10324.x

Cited by 11 publications

(9 citation statements)

References 7 publications

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“…[8] The liver guards on right side so, 90% of these hernias are present on the left side. [4] While, in pregnant females intra-abdominal pressure increases as a consequence of nausea and vomiting till 16th week. As the size of the uterus increases in the second trimester of pregnancy and voluntary force exerted by abdominal muscles play a vital role.…”

Section: Discussionmentioning

confidence: 99%

“…Half of such cases are associated with increased morbidity and mortality of mother and fetus in postpartum period with 24% cases resulting in premature birth. [1,3,4] The survival rate of individuals, with an asymptomatic congenital diaphragmatic hernia is unknown as such cases remain hidden from a clinician or a surgeon. Incidence of asymptomatic congenital diaphragmatic hernia is 0.17%, with a female to male ratio of 17:5.…”

Section: Discussionmentioning

confidence: 99%

“…[3] Surgical intervention is needed if complications arise. [4] These hernias usually involve the left side of diaphragm through a congenital defect or from a trauma over abdomen or chest as the right side has the Hepatic shield below the diaphragm. But the incidence of right sided diaphragmatic hernia is rarest of rare and that too in pregnancy as it presents with life-threatening complications like shortness of breath, obstruction, strangulation, gangrene and perforation of gut.…”

Section: Introductionmentioning

confidence: 99%

“…[5,6,7,8,9] Once initiation of strangulation of intestine sets up then the mortality may shoot up to 22%-80%. [2,3,4] Symptomatic diaphragmatic hernia in a pregnant female is a matter of greater concern and also a surgical emergency associated with high morbidity and mortality. [10] Our case is of a patient with right-sided congenital diaphragmatic hernia presented in primigravida in her second trimester with the features of acute intestinal obstruction.…”

Section: Introductionmentioning

confidence: 99%

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A Congenital Right Sided Diaphragmatic Hernia Presented in Pregnancy: Rare Case Report

Gharde

Dwivedi²,

Gharde

et al. 2020

Preprint

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Background: Diaphragmatic hernias are infrequent and remain undiagnosed till the symptoms arise. One third of these patients are asymptomatic. Its diagnosis is only established on the emergence of gastrointestinal, respiratory or cardiovascular complications. Surgical intervention is needed if complications arise. These Diaphragmatic hernias usually involve the left side of diaphragm either through a congenital defect or from a trauma over abdomen or chest as the right side has a type of protective gear which is the Liver lying below the diaphragm. The occurrence of right sided diaphragmatic hernia is rarest of rare. Patients may present with shortness of breath, obstruction, strangulation, gangrene and perforation of gut. The mortality is very high. Symptomatic diaphragmatic hernia in pregnant females is a matter of greater concern. Case Report: A 21-yr-old female, primigravida, primipara, with 22 weeks gestation, complained of severe abdominal pain and intractable vomiting since the last 7 days and for this acute intestinal obstruction was admitted to the emergency department. At the local Primary Health Center her symptoms were partially relieved by symptomatic management, but due to recurrence of symptoms she was referred to our rural hospital.Her chest radiograph revealed a right sided diaphragmatic hernia with large and small intestine as its content. She had no abdominal or respiratory complaints in past. Initially the patient’s general condition improved by nasogastric aspiration but then she developed tachycardia, tachypnoea, nausea and vomiting despite nasogastric aspiration, so emergency exploration was done. Exploratory laparotomy along with right thoracotomy was performed. As the gut was gangrenous, resection anastomosis was done along with diaphragmatic hernia repair.Conclusion: Diaphragmatic hernia in adults and pregnancy is a very rare entity. The right sided diaphragmatic hernia is rarest of rare that too in pregnancy.What makes this case even extraordinary is, it being the first case in studied literature showing specific right sided presentation during pregnancy, as the rest are left sided. Even though the risk of morbidity and mortality is high, once complications arise, but early intervention improves the outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Congenital Right Sided Diaphragmatic Hernia Presented in Pregnancy: Rare Case Report

Gharde

Dwivedi²,

Gharde

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…They can present to the surgeon as a life-threatening emergency or pose a management dilemma when detected incidentally. 1 Ninety percent of these hernias occur on left side while right sided hernias are very rare as the caudate lobe of liver narrows the pleuroperitoneal canal and prevents herniation. The main life-threatening complications described, include respiratory distress, visceral obstruction, strangulation and gangrene of the herniated viscera, visceral perforation (spontaneous or thoracentesis-induced) and maternal death.…”

Section: Introductionmentioning

confidence: 99%