Document Detail

Congenital diaphragmatic hernia complicated by tension gastrothorax during gastroscopy: report of a case.
MedLine Citation:
PMID:  15674498     Owner:  NLM     Status:  MEDLINE    
Bochdalek's hernia typically manifests early in childhood, but it is uncommon in adults. We report the case of a 77-year-old woman who suffered sudden acute cardiorespiratory distress during an upper gastro-intestinal endoscopy, caused by a massive gastrothorax, confirmed by a chest radiograph and thoracic computed tomography. Laparotomy revealed a posterolateral diaphragmatic defect and an acutely distended stomach occupying the left hemithorax, caused by an incomplete organoaxial volvulus of the organ. The stomach was reduced and secured inside the abdominal cavity by a Nissen fundoplication and the defect was repaired with interrupted sutures. Unfortunately, the patient succumbed to generalized sepsis resulting from Pneumocystis carinii bilateral pneumonia. To our knowledge, this is the first reported case in the English literature of an adult with a congenital posterolateral hernia presenting in this manner. However, it demonstrates that a symptomatic congenital diaphragmatic hernia should be surgically repaired to prevent the numerous complications that may arise, many of which can prove fatal even in an adult.
Anestis Ninos; Evagelos Felekouras; Gerasimos Douridas; Enkel Ajazi; Anna Manataki; Stefanos Pierrakakis; Nikolaos Setakis
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Surgery today     Volume:  35     ISSN:  0941-1291     ISO Abbreviation:  Surg. Today     Publication Date:  2005  
Date Detail:
Created Date:  2005-01-27     Completed Date:  2005-05-27     Revised Date:  2006-08-03    
Medline Journal Info:
Nlm Unique ID:  9204360     Medline TA:  Surg Today     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  149-52     Citation Subset:  IM    
Department of Surgery, Thriassion General Hospital, 18 Levidiou Street, 131.21 Ilion, Athens, Greece.
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MeSH Terms
Endoscopy, Gastrointestinal*
Hernia, Diaphragmatic / complications,  congenital*
Pneumonia, Pneumocystis / etiology
Pneumothorax / etiology*
Stomach Volvulus / etiology*

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