scholarly journals Right-sided Bochdalek hernia in an adult with hepatic malformation and intestinal malrotation

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Naoki Enomoto ◽  
Kazuhiko Yamada ◽  
Daiki Kato ◽  
Shusuke Yagi ◽  
Hitomi Wake ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Abdominal Cavity ◽  
Three Dimensional ◽  
Simulation Software ◽  
3D Simulation ◽  
Diaphragmatic Defect ◽  
Intestinal Malrotation ◽  
Intestinal Loop ◽  
Bochdalek Hernia ◽  
The Right

Abstract Background Bochdalek hernia is a common congenital diaphragmatic defect that usually manifests with cardiopulmonary insufficiency in neonates. It is very rare in adults, and symptomatic cases are mostly left-sided. Diaphragmatic defects generally warrant immediate surgical intervention to reduce the risk of incarceration or strangulation of the displaced viscera. Case presentation A 47-year-old woman presented with dyspnea on exertion. Computed tomography revealed that a large part of the intestinal loop with superior mesenteric vessels and the right kidney were displaced into the right thoracic cavity. Preoperative three-dimensional (3D) simulation software visualized detailed anatomy of displaced viscera and the precise location and size of the diaphragmatic defect. She underwent elective surgery after concomitant pulmonary hypertension was stabilized preoperatively. The laparotomic approach was adopted. Malformation of the liver and the presence of intestinal malrotation were confirmed during the operation. The distal part of the duodenum, jejunum, ileum, colon, and right kidney were reduced into the abdominal cavity consecutively. A large-sized oval defect was closed with monofilament polypropylene mesh. No complications occurred postoperatively. Conclusion Symptomatic right-sided Bochdalek hernia in adults is exceedingly rare and is frequently accompanied by various visceral anomalies. Accurate diagnosis and appropriate surgical repair are crucial to prevent possible incarceration or strangulation. The preoperative 3D simulation provided comprehensive information on anatomy and concomitant anomalies and helped surgeons plan the operation meticulously and perform procedures safely.

Herniation of the Right Renal Pelvis through a Posterolateral Diaphragmatic Defect (Bochdalek Hernia)

Urology ◽  
2020 ◽  
Vol 137 ◽  
pp. e10-e11
Author(s):  
Ashwin Shekar P. ◽  
Dinesh Reddy ◽  
Gaurav Kochhar ◽  
Anuj Dumra ◽  
Shivakumar KS
Keyword(s):  
Renal Pelvis ◽  
Diaphragmatic Defect ◽  
Bochdalek Hernia ◽  
The Right

scholarly journals Adult Bochdalek Hernia with Organo-Axial Gastric Volvulus: Misdiagnosed as Hydropneumothorax

2018 ◽  
Vol 61 (3) ◽  
pp. 108-110 ◽  
Author(s):  
Sugandha Arya ◽  
Saqib Shahab ◽  
Rahul Kumar ◽  
Pankaj Kumar Garg
Keyword(s):  
Abdominal Cavity ◽  
Gastric Volvulus ◽  
Left Pulmonary Artery ◽  
Tube Thoracostomy ◽  
Diaphragmatic Defect ◽  
Bochdalek Hernia ◽  
Adult Type ◽  
Iatrogenic Perforation ◽  
Old Adult ◽  
Food Particles

Bochdalek hernia (BH) in an adult may manifest clinically with a myriad of abdominal or chest symptoms or a combination of them. Diagnosis of an adult BH is usually delayed in view of rarity of the lesion and its varied presentation. A 30-year-old adult gentleman presented to us with a left thoracostomy which was draining pus and ingested food particles. The tube thoracostomy had been performed in another hospital for an apparent left hydropneumothorax before he arrived in our hospital. Computed tomography of Chest and abdomen revealed a left diaphragmatic defect with herniation of stomach, spleen and omentum into the chest with organo-axial volvulus of the stomach. A thoracostomy tube was seen to be traversing through the stomach with its tip located close to the left pulmonary artery. The patient underwent left thoraco-abdominal exploration with dissection and reposition of the hernial contents in the abdominal cavity. The gastric perforations and the diaphragmatic defect were repaired. This case reiterates a well-known fact that an adult type BH must find a place in the differential diagnosis of a hydropneumothorax. Though the adult BH is a rare diagnosis, unawareness or reluctance to consider the possibility of adult BH may prolong the suffering of the patient as it happened in our patient who had iatrogenic perforation of the stomach due to tube thoracostomy.

scholarly journals Subhepatic caecum and appendix - a rare variant in an adult male cadaver

2013 ◽  
Vol 02 (02) ◽  
pp. 093-096
Author(s):  
P. Savithri
Keyword(s):  
Iliac Fossa ◽  
Abdominal Cavity ◽  
Intestinal Loop ◽  
Diagnostic Challenge ◽  
Inferior Surface ◽  
Male Cadaver ◽  
Hypochondriac Region ◽  
Right Lobe ◽  
The Right ◽  
Symptoms And Signs

AbstractIn unusual cases of malrotation or incomplete rotation of caecum , the appendix is not located in the lower right quadrant. When the caecum is high [subhepatic caecum] the appendix is located in the right hypochondriac region and the pain in these cases is located there, not in the lower right quadrant. In this position , the symptoms and signs of acute appendicitis may mimic acute cholecystitis, diagnosis in such cases is a great diagnostic challenge. The author observed this less frequent anomaly in a middle aged male cadaver. After opening the abdomen while tracing peritoneal reflections abnormality was identified. The caecum and appendix were present in relation with inferior surface of liver. Embryologically, the caecal swelling appears as a small conical dilation of the caudal limb of primitive intestinal loop and it is the last part of the gut to reenter the abdominal cavity. It is temporarily located in the right upper quadrant directly below the right lobe of liver. From here it descends into the right iliac fossa. The failure to descend leads to subhepatic caecum.

Usefulness of three-dimensional(3D) simulation software in hepatectomy for pediatric hepatoblastoma

2016 ◽  
Vol 25 (3) ◽  
pp. 236-243 ◽  
Author(s):  
Gang Zhang ◽  
Xian-jun Zhou ◽  
Cheng-zhan Zhu ◽  
Qian Dong ◽  
Lin Su
Keyword(s):  
Three Dimensional ◽  
Simulation Software ◽  
3D Simulation

scholarly journals Incarcerated gallbladder in inguinal hernia: a case report and literature review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
János Tajti ◽  
József Pieler ◽  
Szabolcs Ábrahám ◽  
Zsolt Simonka ◽  
Attila Paszt ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Abdominal Cavity ◽  
Abdominal Ultrasound ◽  
Intestinal Loop ◽  
Emergency Case ◽  
Laboratory Findings ◽  
Midline Laparotomy ◽  
Reactive Protein ◽  
Hernial Sac ◽  
The Right

Abstract Background Treating hernias is one of the oldest challenges in surgery. The gallbladder as content in the case of abdominal hernias has only been reported in a few cases in the current literature. Cholecyst has only been described in the content of an inguinofemoral hernia in one case to date. Case presentation A 73-year-old female patient was admitted to the Emergency Department due to complaints in the right inguinal area, which had started 1 day earlier. The patient complained of cramp-like abdominal pain and nausea. Physical examination confirmed an apple-sized, irreducible hernia in the right inguinal region. Abdominal ultrasound confirmed an oedematous intestinal loop in a 70-mm-long hernial sac, with no circulation detected. Abdominal X-ray showed no signs of passage disorder. White blood cell count and C-reactive protein level were elevated, and hepatic enzymes were normal in the laboratory findings. Exploration was performed via an inguinal incision on the right side, an uncertain cystic structure was found in the hernial sac, and several small abnormal masses were palpated there. The abdominal cavity was explored from the middle midline laparotomy. During the exploration, the content of the hernial sac was found to be the fundus of the significantly ptotic, large gallbladder. Cholecystectomy and Bassini’s repair of the inguinal hernia were performed safely. Conclusions Following a review of the literature, it can be concluded that the finding of incarcerated gallbladder in the content of an inguinal hernia is a rare finding. No other similar emergency case and successful surgical intervention have been reported before.

scholarly journals Three-Dimensional Visualization with Large Data Sets: A Simulation of Spreading Cortical Depression in Human Brain

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Korhan Levent Ertürk ◽  
Gökhan Şengül
Keyword(s):  
Human Brain ◽  
Three Dimensional ◽  
Large Data ◽  
Simulation Software ◽  
3D Simulation ◽  
Data Management System ◽  
Data Sets ◽  
Related Data ◽  
Spreading Cortical Depression ◽  
Cortical Depression

We developed 3D simulation software of human organs/tissues; we developed a database to store the related data, a data management system to manage the created data, and a metadata system for the management of data. This approach provides two benefits: first of all the developed system does not require to keep the patient's/subject's medical images on the system, providing less memory usage. Besides the system also provides 3D simulation and modification options, which will help clinicians to use necessary tools for visualization and modification operations. The developed system is tested in a case study, in which a 3D human brain model is created and simulated from 2D MRI images of a human brain, and we extended the 3D model to include the spreading cortical depression (SCD) wave front, which is an electrical phoneme that is believed to cause the migraine.

scholarly journals A case of Bochdalek hernia with anomalous hepatic lobe heterotopia-case report

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Wajiha Khan ◽  
Adnan Safi ◽  
Asrar Ahmad ◽  
Mehwish Mooghal
Keyword(s):  
Case Report ◽  
Common Type ◽  
Diaphragmatic Defect ◽  
Bochdalek Hernia ◽  
Good Recovery ◽  
Liver Lobe ◽  
Case Presentation ◽  
Hepatic Lobe ◽  
The Right ◽  
Ladd’S Procedure

Abstract Background Bochdalek hernia is the most common type of congenital diaphragmatic hernia (CDH) resulting from postero-lateral diaphragmatic defect. Hepatic heterotopia is very rarely associated with CDH, and hepatic herniation favors the worst prognosis. Case presentation We present a case of a neonate diagnosed with right Bochdalek hernia (BH) with anomalous hepatic lobe heterotopia. Intra operatively, mal-rotated loops were also found to be herniating in the right hemithorax. The mal-rotated loops were reduced back into abdomen after performing Ladd’s procedure and diaphragmatic defect was repaired over the anomalous liver lobe. Baby was discharged on 7th postoperative day and follow-ups showed good recovery. Conclusion This case report discusses the presentation, classification, and significance of this association. Our case report is noteworthy as Bochdalek hernia is very rarely associated with anomalous hepatic lobe.

scholarly journals Bochdalek hernia in adults: A case report

2018 ◽  
Vol 75 (6) ◽  
pp. 628-631
Author(s):  
Anita Ivosevic ◽  
Ivana Meta-Jevtovic ◽  
Vojislav Cupurdija ◽  
Ivan Cekerevac ◽  
Aleksandar Radunovic ◽  
...  
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Imaging Techniques ◽  
Main Bronchus ◽  
Abdominal Cavity ◽  
Proximal Part ◽  
Bochdalek Hernia ◽  
Hernia Sac ◽  
Hernial Sac ◽  
The Right

Introduction. Asymptomatic Bochdalek hernia in adults is a rarity. The aim of this paper is to present a rare case of Bochdalek hernia among adults and to point out to significance of clinical suspicion and important role of imaging techniques in reaching the exact diagnosis of this abnormality. Case report. A patient, aged 68 years, came to the Clinic of Pulmonology complaining of constant dyspnea, coughing and fatigue. Computed tomography (CT) findings were dominated by the large rear right diaphragmatic hernia with the hernial sac that reached the carina trachea and urged the principal bronchi. The stomach, duodenum and proximal part of jejunal winds, as well as a greater amount of omental and mesenteric adipose tissue were localized in hernial sac. Radiography of gastroduodenum showed: entry of the esophagus into the cardia was in the level of the right main bronchus. Stomach was mainly located in the chest (cardia, upper corpus half - to the level of the right main bronchus). Operation was indicated. First, we made right thoracotomy and the hernia sac was separated from the right lung and then we performed median laparotomy and the contents of the hernia sac were returned to the abdominal cavity; diaphragm defect was reconstructed with prolen mesh. Conclusion. We presented a rare case of right sided Bochdalek hernia which was discovered at late age and surgically treated with success.

scholarly journals Intestinal Malrotation: A Rare Cause of Small Intestinal Obstruction

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Mesut Sipahi ◽  
Kasim Caglayan ◽  
Ergin Arslan ◽  
Mustafa Fatih Erkoc ◽  
Faruk Onder Aytekin
Keyword(s):  
Intestinal Obstruction ◽  
Abdominal Cavity ◽  
Acute Intestinal Obstruction ◽  
Intestinal Malrotation ◽  
Normal Position ◽  
Transverse Mesocolon ◽  
Appropriate Treatment ◽  
Small Intestinal ◽  
The Right ◽  
Intestinal Obstructions

Background. The diagnosis of intestinal malrotation is established by the age of 1 year in most cases, and the condition is seldom seen in adults. In this paper, a patient with small intestinal malrotation-type intraperitoneal hernia who underwent surgery at an older age because of intestinal obstruction is presented.Case. A 73-year-old patient who presented with acute intestinal obstruction underwent surgery as treatment. Distended jejunum and ileum loops surrounded by a peritoneal sac and located between the stomach and transverse colon were determined. The terminal ileum had entered into the transverse mesocolon from the right lower part, resulting in kinking and subsequent segmentary obstruction. The obstruction was relieved, and the small intestines were placed into their normal position in the abdominal cavity.Conclusion. Small intestinal malrotations are rare causes of intestinal obstructions in adults. The appropriate treatment in these patients is placement of the intestines in their normal positions.

scholarly journals Late presentation of extrauterine adenomyomas after laparoscopic morcellation at hysterectomy: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammed Nagdi Zaki ◽  
Aafia Mohammed Farooq Gheewale ◽  
Nada Ibrahim ◽  
Ibrahim Abd Elrahman
Keyword(s):  
Case Report ◽  
Transvaginal Ultrasound ◽  
Iliac Fossa ◽  
Abdominal Cavity ◽  
Laparoscopic Hysterectomy ◽  
Pathology Report ◽  
Presacral Space ◽  
Gnrh Analogue ◽  
Power Morcellation ◽  
The Right

Abstract Background An adenomyoma is a well circumscribed form of adenomyosis and can be located within the myometrium, in the endometrium as a polyp, or extrauterine with the last being the rarest presentation amongst the three. With the ongoing advancement in gynecological surgery, the use of electromechanical morcellators have made the removal of large and dense specimens possible with minimally invasive techniques. However, it has also caused an increase in complications which were previously rare. Whilst the tissue is being grinded within the abdominal cavity, residual tissue can spread and remain inside, allowing for implantation to occur and thereby giving rise to recurrence of uterine tissue as a new late postoperative complication. Case presentation A 45-year-old woman presented with worsening constipation and right iliac fossa pain. Her past surgical history consists of laparoscopic supra-cervical hysterectomy that was indicated due to uterine fibroids. Computerized tomography and magnetic resonance imaging were done, which showed an irregular lobulated heterogeneous mass seen in the presacral space to the right, located on the right lateral aspect of the recto-sigmoid, measuring 4.5 × 4.3 × 4.3 cm in size. A transvaginal ultrasound revealed a cyst in the left ovary. The patient had a treatment course over several months that included Dienogest (progestin) and Goserelin (GnRH analogue) with add-back therapy. In line with the declining response to medications, the patient was advised for a laparoscopic ovarian cystectomy. During the surgery, an additional lesion was found as a suspected fibroid and the left ovarian cyst was identified as pockets of peritoneal fluid which was sent for cytology. The surgical pathology report confirmed adenomyosis in both specimens, namely the right mass and the initially suspected fibroid. Conclusion In this case report, we showcase a rare occurrence of an extrauterine adenomyoma presenting two years post laparoscopic morcellation at hysterectomy. This poses questions regarding the benefits versus risks of power morcellation in laparoscopic hysterectomy.

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