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Congenital retrosternal hernias of Morgagni: Manifestation and treatment in children
BACKGROUND: Due to scarcity of congenital diaphragmatic hearnias of Morgagni (CDHM), non-specific clinical presentation in the pediatric age group, we aimed to investigate the incidence, clinical manifestations, anatomical characteristics, and develop diagnostic algorithm and treatment of CDHM in ch...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4955447/ https://www.ncbi.nlm.nih.gov/pubmed/27251653 http://dx.doi.org/10.4103/0189-6725.182557 |
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author | Slepov, Oleksii Kurinnyi, Sergii Ponomarenko, Oleksii Migur, Mikhailo |
author_facet | Slepov, Oleksii Kurinnyi, Sergii Ponomarenko, Oleksii Migur, Mikhailo |
author_sort | Slepov, Oleksii |
collection | PubMed |
description | BACKGROUND: Due to scarcity of congenital diaphragmatic hearnias of Morgagni (CDHM), non-specific clinical presentation in the pediatric age group, we aimed to investigate the incidence, clinical manifestations, anatomical characteristics, and develop diagnostic algorithm and treatment of CDHM in children. MATERIALS AND METHODS: The patients’ records of children with CDHM treated in our hospital during past 20 years were retrospectively reviewed for the age at diagnosis, gender, clinical findings, anatomical features, operative details and outcome. RESULTS: Since 1995 to 2014 we observed 6 (3 boys, 3 girls) patients with CDHM, that comprise 3.2% of all congenital diaphragmatic hernia cases (n = 185). Age at diagnosis varied from 3 mo. to 10y.o. Failure to thrive was main symptom in 4 patients, followed by recurrent respiratory infections (n = 3), dyspnea (n = 3), and gastrointestinal manifestations: constipation (n = 2), abdominal pain (n = 1). Work-up consisted of plain X-ray for all (n = 6), upper GI (n = 3), barium enema (n = 2), sonography (n = 6) and CT (n = 2). Abdominal approach used in 5 patients, and thoracotomy in one. Herniated contents were: liver lobes (n = 4), transverse colon (n = 3) and greater omentum (n = 1). 5 had right-sided lesion, 1- left-sided. Defect repaired using local tissues. Post-operative course was uneventful; all patients appeared well during follow-up. CONCLUSION: CDHM is very uncommon anomaly, very occasionally diagnosed at the early age. Failure to thrive and recurrent respiratory infections are most frequent clinical manifestations. In suspected CDHM we advocate the following work-up: plain chest and abdominal X-ray, contrast study (upper GI series or barium enema), ultrasonographic screen and CT scan. Surgical repair via abdominal approach, using local tissues and hernia sac removal is preferred. |
format | Online Article Text |
id | pubmed-4955447 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-49554472016-09-01 Congenital retrosternal hernias of Morgagni: Manifestation and treatment in children Slepov, Oleksii Kurinnyi, Sergii Ponomarenko, Oleksii Migur, Mikhailo Afr J Paediatr Surg Original Article BACKGROUND: Due to scarcity of congenital diaphragmatic hearnias of Morgagni (CDHM), non-specific clinical presentation in the pediatric age group, we aimed to investigate the incidence, clinical manifestations, anatomical characteristics, and develop diagnostic algorithm and treatment of CDHM in children. MATERIALS AND METHODS: The patients’ records of children with CDHM treated in our hospital during past 20 years were retrospectively reviewed for the age at diagnosis, gender, clinical findings, anatomical features, operative details and outcome. RESULTS: Since 1995 to 2014 we observed 6 (3 boys, 3 girls) patients with CDHM, that comprise 3.2% of all congenital diaphragmatic hernia cases (n = 185). Age at diagnosis varied from 3 mo. to 10y.o. Failure to thrive was main symptom in 4 patients, followed by recurrent respiratory infections (n = 3), dyspnea (n = 3), and gastrointestinal manifestations: constipation (n = 2), abdominal pain (n = 1). Work-up consisted of plain X-ray for all (n = 6), upper GI (n = 3), barium enema (n = 2), sonography (n = 6) and CT (n = 2). Abdominal approach used in 5 patients, and thoracotomy in one. Herniated contents were: liver lobes (n = 4), transverse colon (n = 3) and greater omentum (n = 1). 5 had right-sided lesion, 1- left-sided. Defect repaired using local tissues. Post-operative course was uneventful; all patients appeared well during follow-up. CONCLUSION: CDHM is very uncommon anomaly, very occasionally diagnosed at the early age. Failure to thrive and recurrent respiratory infections are most frequent clinical manifestations. In suspected CDHM we advocate the following work-up: plain chest and abdominal X-ray, contrast study (upper GI series or barium enema), ultrasonographic screen and CT scan. Surgical repair via abdominal approach, using local tissues and hernia sac removal is preferred. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC4955447/ /pubmed/27251653 http://dx.doi.org/10.4103/0189-6725.182557 Text en Copyright: © African Journal of Paediatric Surgery http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Slepov, Oleksii Kurinnyi, Sergii Ponomarenko, Oleksii Migur, Mikhailo Congenital retrosternal hernias of Morgagni: Manifestation and treatment in children |
title | Congenital retrosternal hernias of Morgagni: Manifestation and treatment in children |
title_full | Congenital retrosternal hernias of Morgagni: Manifestation and treatment in children |
title_fullStr | Congenital retrosternal hernias of Morgagni: Manifestation and treatment in children |
title_full_unstemmed | Congenital retrosternal hernias of Morgagni: Manifestation and treatment in children |
title_short | Congenital retrosternal hernias of Morgagni: Manifestation and treatment in children |
title_sort | congenital retrosternal hernias of morgagni: manifestation and treatment in children |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4955447/ https://www.ncbi.nlm.nih.gov/pubmed/27251653 http://dx.doi.org/10.4103/0189-6725.182557 |
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