Routes of Transdiaphragmatic Migration from the Abdomen to the Chest

Sharma, Rekha; Meyer, Cristopher A.; Frazier, Aletta Ann; Martin, Maria D.; Kusmirek, Joanna; Kanne, Jeffrey P.

doi:10.1148/rg.2020200026

Cited by 12 publications

(9 citation statements)

References 31 publications

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“…Unusual clinical presentations described in case reports include acute peritonitis, ischemic colitis, sciatica, empyema, and nephrobronchial fistula, [10–14] XGPN with transdiaphragmatic extension through erosion is rare. [15] Identical bacterial species with the same drug spectrum from both nephrostomy urine and sputum cultures supported our findings. The negative blood culture suggests that the lung abscess was probably due to XGPN with local extension rather than due to hematogenous spread.…”

Section: Discussionsupporting

confidence: 83%

Lung abscess with chronic cough secondary to xanthogranulomatous pyelonephritis: A rare case report

et al. 2023

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Rationale: Xanthogranulomatous pyelonephritis (XGPN) is a form of chronic pyelonephritis caused by chronic calculus obstruction and bacterial infection, leading to the destruction of the renal parenchyma and calyces. Conservative treatment is usually not sufficient, and surgical intervention is still the main curative approach. XGPN with transdiaphragmatic extension and lung abscess formation is a rare condition. Patient concerns: We report a 64-year-old woman who presented with persistent productive cough. Diagnoses: Lung abscess secondary to XPGN. Both nephrostomy urine and sputum cultures showed Proteus mirabilis infection with the same antibiotic sensitivity spectrum, but blood culture was negative. Interventions: Laparoscopic radical nephrectomy and prolonged antibiotic treatment. Outcomes: The lung abscess and cough gradually resolved in 1 month after nephrectomy. Conclusion: Lung abscess secondary to transdiaphragmatic extension of XGPN is rare but should be considered in patients with lower lung infections that are unresponsive to treatment, especially infections due to unusual respiratory pathogens such as P mirabilis .

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Section: Discussionsupporting

confidence: 83%

Lung abscess with chronic cough secondary to xanthogranulomatous pyelonephritis: A rare case report

et al. 2023

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“…These include the iliopsoas muscle, whose fascia forms the medial arcuate ligament. Lateral to this is the lateral arcuate ligament, which is the result of the quadratus lumborum muscle insertion, on which the kidney rests 7. In our patient, the purulent material ascended along the left iliopsoas muscle from the pelvic inlet to the pararenal fat, in a similar manner to that found in perinephric abscesses secondary to perforated diverticulitis 15 16.…”

Section: Discussionsupporting

confidence: 67%

“…Regarding ascending mechanisms of infection from abdomen to thorax, several anatomical structures connecting both cavities have been described. In cases of intra-abdominal infection, ascent may occur through the oesophageal hiatus, the inferior vena cava or by direct extension through the diaphragm 6 7. In contrast, retroperitoneal infections extend into the pleural and mediastinal cavity via the retrocrural space,5 formed by the aortic hiatus and the prevertebral and paravertebral spaces.…”

Section: Discussionmentioning

confidence: 99%

“…Although the pathophysiological mechanisms are not entirely clear, numerous transdiaphragmatic pathways connecting both abdominal and thoracic cavities have been described, including the oesophageal hiatus, the hiatus of the inferior vena cava or the aortic hiatus 6. Although less well-known, medial and lateral arcuate ligaments have also been suggested as potential gateways to the pleural cavity from the retroperitoneum 7…”

Section: Introductionmentioning

confidence: 99%

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Pleural empyema secondary to perforated diverticulosis due to biliary neoplasia infiltration

Vera

Cuadra²,

Pinos³

et al. 2023

BMJ Case Rep

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A long-term female smoker presented to the emergency department with cough, greenish mucus and dyspnoea, without fever. The patient also reported abdominal pain and significant weight loss in recent months. Laboratory tests showed leucocytosis with neutrophilia, lactic acidosis and a faint left lower lobe consolidation on chest X-ray, for which she was admitted to the pneumology department and started on broad-spectrum antibiotherapy. After 3 days of clinical stability, the patient deteriorated rapidly, with worsening of analytical parameters and coma. The patient died a few hours later. Given the rapid and unexplained evolution of the disease, a clinical autopsy was requested, which revealed a left pleural empyema caused by perforated diverticula by neoplastic infiltration of biliary origin.

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“…It is so primary to functional integration that in the rat model, the motion of breathing begins in the fetus on the thirteenth day of gestation [33]. In the adult human, the diaphragm is a very thin muscle (2–4 mm), with diverse morphology and movement having differences between the right and left areas [34]. The purely connective area and the area of confluence of the contractile fibers are defined as the central tendon or tendon center.…”

Section: Diaphragmatic Functional Anatomymentioning

confidence: 99%

The Importance of the Posterolateral Area of the Diaphragm Muscle for Palpation and for the Treatment of Manual Osteopathic Medicine

Bordoni

Walkowski²,

Escher

et al. 2021

Complement Med Res

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The eupneic act in healthy subjects involves a coordinated combination of functional anatomy and neurological activation. Neurologically, a central pattern generator, the components of which are distributed between the brainstem and the spinal cord, are hypothesized to drive the process and are modeled mathematically. A functionally anatomical approach is easier to understand although just as complex. Osteopathic manipulative treatment (OMT) is part of osteopathic medicine, which has many manual techniques to approach the human body, trying to improve the patient’s homeostatic response. The principle on which OMT is based is the stimulation of self-healing processes, researching the intrinsic physiological mechanisms of the person, taking into consideration not only the physical aspect, but also the emotional one and the context in which the patient lives. This article reviews how the diaphragm muscle moves, with a brief discussion on anatomy and the respiratory neural network. The goal is to highlight the critical issues of OMT on the correct positioning of the hands on the posterolateral area of the diaphragm around the diaphragm, trying to respect the existing scientific anatomical-physiological data, and laying a solid foundation for improving the data obtainable from future research. The correctness of the position of the operator’s hands in this area allows a more effective palpatory perception and, consequently, a probably more incisive result on the respiratory function.

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Routes of Transdiaphragmatic Migration from the Abdomen to the Chest

Cited by 12 publications

References 31 publications

Lung abscess with chronic cough secondary to xanthogranulomatous pyelonephritis: A rare case report

Lung abscess with chronic cough secondary to xanthogranulomatous pyelonephritis: A rare case report

Pleural empyema secondary to perforated diverticulosis due to biliary neoplasia infiltration

The Importance of the Posterolateral Area of the Diaphragm Muscle for Palpation and for the Treatment of Manual Osteopathic Medicine

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