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首页> 外文期刊>Journal of Clinical and Diagnostic Research >An Adult Recurrent DiaphragmaticHernia with a Near Complete Defect:A Rare Scenario
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An Adult Recurrent DiaphragmaticHernia with a Near Complete Defect:A Rare Scenario

机译：成人复发性Dia肌疝伴几乎完全缺损：一种罕见的情况

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A diaphragmatic hernia is usually seen in childhood and it is rare in adults. We are reporting a case of a 73 years old male who presented with pain and distension of the abdomen, breathlessness and constipation. He was operated 10 years back for a diaphragmatic hernia, during which a splenectomy, omentectomy and a mesh repair were done. X-rays and CT scans of the chest and the abdomen showed a recurrent diaphragmatic hernia on the left side. Laparotomy and left sided thoracotomy was done. The contents being the small bowel and the colon, they were reduced. The left hemi-diaphragm was completely absent, except for an anterior thin rim of tissue. A short ischaemic jejunal segment was resected. A dual mesh was used to reconstruct the left hemi-diaphragm in a contaminated field and it was fixed to the intact rim and to the other available tissues around the defect. The post-operative chest X-rays showed the mesh to be in place. The patient had an uneventful recovery. No signs of recurrence were found during 2 years of follow-up. Adult diaphragmatic hernias, once they are diagnosed, are managed surgically to prevent complications. Difficult scenarios may be encountered, for which the surgical strategy should be individualized and the immediate postoperative complications should be dealt appropriately.
机译：childhood肌疝气通常见于儿童期，成人很少见。我们正在报告一例73岁男性，他的腹部疼痛和胀大，呼吸困难和便秘。 10年前，他因for肌疝气而接受手术，其间做了脾切除术，网膜切除术和网状修复术。胸部和腹部的X射线和CT扫描显示左侧复发性diaphragm肌疝。进行了剖腹术和左侧胸廓切开术。内容物是小肠和结肠，它们被减少了。除了组织的前缘薄弱以外，完全没有左半膜肌。切除了短暂的缺血性空肠段。使用双重网格在受污染的田野中重建左半膜，并将其固定到完整的边缘和缺损周围的其他可用组织上。术后胸部X线检查显示网片到位。病人恢复良好。在两年的随访中未发现复发迹象。一旦诊断出成人diaphragm肌疝，就可通过手术治疗以预防并发症。可能会遇到困难的情况，应根据具体情况制定手术策略，并适当处理术后即刻并发症。

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