• Journal of Chest Surgery
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• v.16 no.2
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• pp.255-259
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• 1983

Thirteen cases of traumatic diaphragmatic injuries treated at the Dept. of Thoracic & Cardiovascular Surgery in Kyung-Hee University Hospital from Jan. 1973 to Dec. 1982, were reviewed in this study. 1. Of 13 cues, 11 were male and 2 were female, a ratio of 5.5:1. This ratio revealed high incidence in male patients. The age distribution was ranged from 2 to 59 years. 2. The causes of traumatic diaphragmatic injuries; 6 were traffic accidents, 4 were stab wounds, 1 was falling down, 1 was gun shot wound and 1 was kick. 3. Operation were performed in 11 patients. No operation was done in 2 patients. 4. There were 100% of other associated injuries, the most frequent was having hemothorax. 5. 2 cases of death occurred in not operated patients. One was intracranial hematoma, and the other was hypertensive encephalopathy.

• Journal of Chest Surgery
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• v.2 no.1
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• pp.59-64
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• 1969

Three cases of traumatic diaphragmatic hernia were repaired in this department from June 1967 to Nov.1968. The first case, a 14 year old girl, was diagnosed as diaphragmatic hernia during the operation of the diffuse peritonitis from jejunaI perforation 3 days after the traffic accident at local clinic and she was transfered to this hospital after the closure of the perforated jejunum. Herniated stomach, transverse colon, spleen and left lobe of the liver were repositioned and the diaphragmatic rupture at the posterolateral portion of the left diaphragm was repaired with two layer sutures by transthoracic approach. The second case. a 26 year old man. was diagnosed immediately after the traffic accident at local clinic and transfered to this hospital 24 hours later. Herniated and distended stomach, transverse colon and jejunum were repositioned and the large diaphragmatic rupture, about 9 cm in length, from the posterolateral portion to the base of the pericardium was directly repaired with two layer sutures. The third case, a 26 year old man, who had a history of stab wound at left lower lateral chest two years ago,was admitted with the sudden onset of abdominal pain and vomiting. The diaphragmatic hernia was confirmed with barium enema. The herniated stomach and transverse colon through the defect, about 3.5 cm in diameter, at anterolateral portion of the left diaphragm, were repositioned and the defect was repaired with two layer sutures. All of the cases recovered uneventfully.

• Investigative Magnetic Resonance Imaging
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• v.1 no.1
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• pp.154-161
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• 1997

Purpose: Traumatic rupture of the diaphragm is not easy to diagnose and often delayed. Delayed diagnosis of diaphragmatic rupture accompanied by higher chances of strangulation of herniated viscera which may result in higher morbility and mortality. The purpose of this study was to evaluate diagnostic accuracy of spiral CT, MRI and US for the diagnosis of diaphragmatic rupture in an animal model. Materials and Methods: Small, medium, and large sized transabdominal diaphragmatic ruptures were surgically made in experimental rabbits and then followed up with spiral CT, MR!, and US at 1 day, 3 day, and 1 week after operation. Results: US was superior to MR! or spiral CT in diagnosis of diaphragmatic rupture(P(0.05). The sensitivity and specificity were 94.4% and 92.9% for US, 54.0% and 85.7% for MRI, and 46.0% and 78.6% for spiral CT, respectively. The size of laceration was not related to diagnostic sensitivity in US. Sensitivity of MRI and spiral CT increased as the size of laceration were larger, but no statistical significance was present(P>0.05). All experimental animals developed pleural effusion or hemothorax one day after operation. In acute phase, US and MRI were more sensitive than spiral CT in detecting diaphragmatic rupture. Spiral CT was more sensitive than US and MRI in delayed phase but without statistical significance(P>0.05). In the experimental rabbits with accompanying visceral hernia through the diaphragmatic defect, diagnostic accuracy was found equally high among three image modalities(P>0.05). Conclusion: This study indicates that US is the most accurate diagnostic method in detecting injury to the diaphragm in a rabbit model. The findings obtained in this experimental study can be applied to the diaphragmatic rupture of human being.

• Journal of Chest Surgery
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• v.36 no.12
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• pp.985-990
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• 2003

Bilateral diaphragmatic paralysis is a rare disease. It is caused by trauma, cardiothoracic surgery, neuromuscular disorders, corvical spondylosis, and infection. A 60 year-old male patient developed bilateral diaphragmatic paralysis after an on-bloc resection of thymic carcinoma which invaded the right upper lobe, pericardium, superior vena cava and innominate vein. Severe respiratory difficulty developed and ventilator weaning was impossible. We performed bilateral diaphragmatic plication. After the operation, satisfactorily ventilator weaning and sleeping in supine position were possible; therefore, we report this case.

• Journal of Veterinary Clinics
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• v.35 no.5
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• pp.237-239
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• 2018

A 2 months old female Korean domestic shorthair cat weighing 1.2 kg was come to hospital because of respiratory discomfort and lethargy. Heart sounds was more intense and clear on the right side than the left. On radiographic views, loss of the normal diaphragm line, undistinguishable shadow of heart, shadow of gas-containing intestines could be observed in thoracic cavity. Diaphragmatic herniorrhaphy was performed by using propofol 8 mg/kg IV and isoflurane without any complication. On 7th day after the operation, almost all the clinical signs and radiographs including diaphragmatic line, cardiac silhouette, liver and small intestines were turned to normal.

• Advances in pediatric surgery
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• v.10 no.2
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• pp.142-144
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• 2004

A one day old female infant was brought to the emergency room suffering from shortness of breath. An x-ray revealed the gastrointestinal tract in the right thoracic cavity. An emergency operation demonstrated eventration of the diaphragm, and a plication was performed. The baby was discharged without complication and has been followed up in the out patient clinic. Congenital diaphragmatic eventuation requiring emergency operation is rare.

• Advances in pediatric surgery
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• v.2 no.2
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• pp.129-132
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• 1996

This is a case report of a sliding hiatal hernia with severe gastroesophageal reflux(GER) after repair of congenital diaphragmatic hernia(CDH). It was not possible to determine whether the hiatal hernia is a de novo lesion which was missed at the original operation or a consequence of overzealous repair of the Bochdalek defect at the expense of weakening of the diaphragmatic crura. This case demonstrates that a sliding hiatal hernia can be a cause of severe gastroesophageal reflux that should be managed surgically.

• Journal of Chest Surgery
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• v.27 no.8
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• pp.643-649
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• 1994

We evaluated sixteen patients of traumatic diaphragmatic injuries that we have experienced from Jan. 1987 to Aug 1993. Age was ranged from 6 to 71 years, predominantly in the fourth and fifth decades. 13 were male and 3 were female, a ratio of 4.3: 1. Blunt trauma was develped in 11 [Lt 7, Rt 4], penetrating trauma in 5 [Lt 2, Rt 3]. Preoperative diagnosis of diaphragmatic injury was possible in 8 patients [72.2 %] in blunt trauma, and 1 patient [20 %] in penetrating trauma. 8 cases[54.5%] in blunt trauma, and 4 cases in penetrating trauma were treated within 24 hours,meanwhile, patients treated after 10 days were 3, all by blunt trauma.The repair of 16 cases were performed with thoracic approach in 4 cases, thoracoabdominal approach in 3 cases, and abdominal approach in 9 cases. The herniated organs in thorax were stomach [5], colon [3], liver [2], and pancreas [1]. Postoperative complication were developed in 9cases[56.3%] significantly related with delayed operation time [p < 0.01 ]. Hospital mortality was 12.5 % [2/16], and the causes of death were hypovolemic shock in one and hepatic failure due to portal vein rupture in another.

• Journal of Sasang Constitutional Medicine
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• v.24 no.1
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• pp.66-74
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• 2012

1. Objectives : The purpose of this case study is to report that the general symptoms in 83 years-old female pateint with diaphragmatic hernia improved through oral administration of Taeeumjowi-tang(太陰調胃湯) 2. Methods : We considered the patient as Taeeumin, and administered Taeeumjowi-tang(太陰調胃湯) to improve chief complaints, such as general weakness, anorexia, sense of distension, dyspnea. The change of symptoms were evaluated by VAS(visual analogue score). 3. Results : The patient received hospital treatment for 4 weeks, and the chief complaints such as general weakness, anorexia, sense of distension, dyspnea improved in general 4. Conclusions : The patient with the above symptoms (general weakness, anorexia, sense of distension, dyspnea) was confirmed as diaphragmatic hernia by chest CT scan. But the patient decided not to have surgical operation. Observating the progress, we treated the patient through oral administration of Taeeumjowi-tang(太陰調胃湯), acupuncture and moxibustion treatment. And the general symptoms improved.

• Journal of Chest Surgery
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• v.21 no.1
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• pp.175-183
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• 1988

Congenital diaphragmatic hernia [CDH] is a surgical emergency in the newborn infant because it causes severe cardiorespiratory distress. Congenital diaphragmatic eventration [CDE] may also produce severe cardiorespiratory distress in the newborn infant. CDH is an anatomically simple defect that can be easily repaired by reduction of the displaced viscera from the pleural cavity and closure of the diaphragmatic defect. But these infants mortality has not been reduced and still remains very high. The barrier to survival is pulmonary parenchymal and vascular hypoplasia as well as the complex syndrome of persistent fetal circulation. Between May, 1985 and Oct, 1987, 4 neonates with CDH and 1 neonate with CDE were seen in respiratory distress within 12 hrs of birth at St. Francisco general hospital. Each had severe acidosis and hypoxia. And was transferred from a local clinic. They were surgically repaired within 24 hrs of birth. Three neonates lived and two died. Two of the three neonates with CDH operated in the first 6 hrs died. The remaining two [one with CDH, the other with CDE] operated between 6hrs and 24 hrs lived. One case of mortality was combined with bilateral pulmonary hypoplasia and contralateral pneumothorax. The other one case of mortality was combined with complex syndrome of persistent fetal circulation after honeymoon period.