Ultrasound monitoring of diaphragm activity in bilateral diaphragmatic paralysis.

Recovery of diaphragm activity after bilateral diaphragmatic paralysis was monitored in a term infant using a mechanical sector scanner fitted with a 5 MHz transducer. The ratio of diaphragmatic excursion during spontaneous breathing and ventilator assistance was used an objective measure for comparison of diaphragmatic activity during recovery. Ultrasound assessment of diaphragm contraction may be used to study progress in diaphragmatic paralysis.     

婴儿心脏手术后膈肌麻痹的手术治疗

目的回顾性分析阜外心血管医院应用膈肌折叠术治疗婴儿心脏手术术后膈肌麻痹资料，讨论膈肌折叠术适应证及其使患儿脱离呼吸机的益处。方法1996年10月-2005年10月完成9个月以下婴儿心内直视手术2310例，同期术后经B超或／和X线透视诊断膈肌麻痹12例，患儿平均手术年龄3个月（5d～9个月），平均体重5．1（4-8）kg，其中轻度营养不良者7例，中度营养不良者2例。均行膈肌折叠术，对这些患儿的临床资料进行回顾分析。结果心脏手术术后38（5～73）d诊断膈肌麻痹；术后41（5～73）d接受膈肌折叠术。1例全身感染、感染中毒性休克死亡。ICU滞留时间54（2-106）d，住院时间65（29～159）d。结论9个月以下、低体重、营养不良等高危患儿行膈肌折叠术，有利于脱离呼吸机或改善呼吸状态。     

Lymphangioma of the right diaphragm

Intrathoracic extramediastinal lymphangioma is a rare entity; only four cases have been described in the literature, of which one was in a child. This report describes a 9-year-old girl with an infected lymphangioma of the right diaphragm who presented with chest pain and fever. The preoperative diagnosis was a Morgagni hernia, but the correct diagnosis was made at operation. The lesion was amenable to resection, which proved to be curative. Correspondence to: T. Seo     

Inflammatory pseudotumor of the diaphragm

A 5-year-old-boy presented with a right pleural effusion and fever. A tumorous mass was located between the right lung and the liver. The boy underwent a right thoracotomy with excision of the tumor and the adherent parts of the right hemidiaphragm. Histology and immunohistochemistry showed an inflammatory pseudotumor of the diaphragm. This is the first reported case of an inflammatory pseudotumor in this location. A brief review of the heterogeneous theories about the pathogenesis and the different therapeutic regimens for this rare neoplastic entity are discussed. Accepted: 17 June 1998     

Spontaneous rupture of the diaphragm

A 2.5 year old girl with metachromatic leukodystrophy presentedwith acute respiratory distress and was initially wrongly diagnosedwith pneumothorax. Barium meal showed bowel loops in the lefthemithorax, which prompted surgical intervention; spontaneous ruptureof the diaphragm was diagnosed at surgery.

     

Congenital eventration of the diaphragm

Six cases of congenital eventration of the diaphragm are presented. The abnormality was on the left side in all the patients. The clinical presentation and surgical treatment has been discussed. There was no operative mortality or significant morbidity.     

Obstetric Ultrasound:

Uses of ultrasound are expanding to include a variety of diagnostic activities ranging from evaluating detailed anatomy, to identifying at-risk fetuses, to assessing uterine insufficiency. Because of these uses, ultrasound is a necessary component of prenatal care and research related to fetal and maternal health. This paper deals on a basic level with how ultrasound is used in obstetrics.