Congenital eventration of the diaphragm — 45 years' perspective

Fifty-five children with congenital eventration of the diaphragm were operated upon in a single tertiary-care children's hospital during the 45-year period from 1948 to 1992. The study was divided into three periods: 1948–1962, 1963–1977, 1978–1992. There were 14 patients in the first group, 26 in the second, and 15 in the third. Children later in the series presented earlier and with more acute symptoms. Mortality was related to severe pulmonary hypoplasia and associated anomalies, especially chromosomal defects: 14% during the first period, 27% during the second, and 7% during the third.     

先天性膈肌发育缺陷疾病的修复问题

先天性膈肌发育缺陷疾病包括①食管裂孔疝;②先天性膈疝;③膈膨升。报道51例患儿的诊治经验,介绍不同的膈肌发育缺陷疾病,各自不同的病理解剖特点。强调在手术修复中按照其病理解剖及病理生理特点,选用正确术式以提高疗效。     

儿童肺结核并发膈膨升

我院自１８７６年至１９９６年收治１０例儿童肺结核并发左侧膈膨升。男６例，女４例。年龄３－１５岁。原发综合症７例，支气管淋巴结核２例，粟粒型肺结核１例。１０例均并发左侧膈膨升。作者的经验该病的可能原因是支气管淋巴结结核损伤了膈神经，膈神经麻痹致膈膨升。     

Diagnosis of delayed onset right-sided congenital diaphragmatic hernia using ultrasonic and radionuclide imaging

A right-sided Bochdalek diaphragmatic hernia is often a difficult diagnosis to establish because the onset of clinical symptoms may be delayed or preceded by Group B streptococcal pneumonia, or may produce confusing findings on chest radiographs. In two cases, real time ultrasonography and radionuclide liver scans readily diagnosed diaphragmatic interruption and intrathoracic herniation of the liver. Offprint requests to: A. R. Nussbaum     

Abdominal muscle flap repair for large defects of the diaphragm

Repair of a large diaphragmatic defect in congenital diaphragmatic hernia (CDH) and eventration of the diaphragm (DE) is difficult, especially when this is an unexpected finding at surgery. A patch of synthetic material may not be available at short notice, especially in developing countries. We describe the repair of nine such defects by using an abdominal muscle flap comprising the transversus abdominis and internal oblique muscles based on the intercostal and subcostal vessels. Although reports of similar flap repairs have been published in the literature [1–5], these employed a subcostal incision for abdominal entry, which we believe jeopardizes the flap’s vascularity. Thus, we prefer to use an upper abdominal midline incision for abdominal entry in all cases of CDH and DE.     

Eventration of the diaphragm and associations

Eventration of the diaphragm, most often an isolated entity, and detected incidentally, has been known to be associated with several genetic syndromes. Authors report their experience of seeing diaphragmatic eventration in association with Poland syndrome and wandering spleen syndrome and briefly discuss the literature.     

Congenital eventration of the diaphragm

Ultrasound was utilized in 3 infants to diagnose preoperatively eventration of the diaphragm. In all children the organ simulating a chest mass was the liver.