A Case of Iatrogenic Diaphragmatic Hernia Caused by a Diaphragmatic Relaxing Incision during Hiatal Hernia Repair
نویسندگان
چکیده
症例は82歳の女性で，7年前にIV型の巨大食道裂孔ヘルニアに対して腹腔鏡下食道裂孔ヘルニア修復術を施行した．食道裂孔が極めて大きく，裂孔縫縮の際には，裂孔左側に横隔膜減張切開を要した．減張切開部は縫合閉鎖した後，裂孔修復部とともにメッシュで被覆した．術後数年後より呼吸困難感が出現し，6年目には近医で在宅酸素療法が導入されたCT所見上，食道裂孔の左側に横隔膜欠損部があり，腸管が左胸腔内へと脱出し左肺を圧排していた．減張切開部が裂けたことによる医原性横隔膜ヘルニアと診断し，腹腔鏡下横隔膜ヘルニア修復術を施行した．ヘルニア門は10 cmあり，脱出臓器とヘルニア門は強固に癒着していた．脱出臓器を腹腔内に還納した後，ヘルニア門を縫合閉鎖し，メッシュで被覆した．術後1年3か月が経過したが再発は認めていない．今回，我々は横隔膜減張切開が原因となった横隔膜ヘルニアの1例を経験したため報告する．
منابع مشابه
Laparoscopic Repair of a Chronic Iatrogenic Diaphragmatic Hernia
We report the diagnosis and repair of a chronic, iatrogenic diaphragmatic hernia using minimally-invasive techniques. A 69-year-old man presented with intermittent abdominal and shoulder pain. He had previously undergone laparoscopic Nissen fundoplication in which a grasper-induced puncture injury to the left hemidiaphragm was noted but not repaired. Radiographs and CT imaging diagnosed a left ...
متن کاملLaparoscopic repair of a traumatic diaphragmatic hernia.
The laparoscopic diagnosis and repair of an unusual diaphragmatic hernia are described. Extensive radiological assessment failed to demonstrate the injury, which was diagnosed by laparoscopy 5 weeks after the initial presentation. The diaphragmatic tear was adjacent to the costal margin and was repaired using a novel percutaneous technique. The place of laparoscopy in blunt abdominal trauma is ...
متن کاملHiatal hernia and diaphragmatic eventration in a leopard (Panthera pardus).
A 1-yr-old male leopard (Panthera pardus) presented for intermittent anorexia, emaciation, and generalized muscle wasting. Plain radiographs, ultrasonography, and esophageal endoscopy led to a diagnosis of diaphragmatic eventration with probable concurrent hiatal hernia. An exploratory laparotomy confirmed both diagnoses, and surgical repair and stabilization were performed. After surgery, the ...
متن کاملAnesthetic management of diaphragmatic hernia repair in a dog: a case report and literature review of anesthetic techniques
This case report describes the anesthetic management and ventilation technique in the surgical treatmentof traumatic diaphragmatic hernia in a dog. A 5-month-old 8-kg female terrier with a history of car accidentwas presented for femoral fracture repair. Before anesthetic induction, marked tachypnea and dyspnea werenoted. Diaphragmatic hernia was diagnosed based upon radiographic and ultrasonog...
متن کاملA case of retrosternal diaphragmatic hernia.
Following the report of an example of bilateral parasternal diaphragmatic hernia (Warwick-Brown, 1952) an example of a type of hernia in this region is now described from a specimen encountered during a recent routine necropsy at St. Bartholomew's Hospital. This type of hernia has not been described before. The patient was a woman aged 70 who died in the post-operative period following the abdo...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
ژورنال
عنوان ژورنال: The Japanese Journal of Gastroenterological Surgery
سال: 2023
ISSN: ['1348-9372', '0386-9768']
DOI: https://doi.org/10.5833/jjgs.2022.0015