Diaphragmatic Hernia

Overview :diaphragmatic hernia is a defect or tear in the diaphragm that allows abdominal organs to enter the thoracic cavity

It can be congenital (rare) or acquired, most commonly due to trauma

History

Clinical signs

Diagnosis

history of falling from the 3rd floor


  • Dyspnea
  • Tachypnea
  • Paradoxical breathing
  • Shallow or restrictive breathing
  • Open-mouth breathing
  • Cyanosis
  • Increased abdominal effort
  • Orthopnea


1. X-Rays

  • Loss of normal diaphragmatic line
  • Loops of gas-filled bowel visible within the thoracic cavity
  • Heart silhouette displaced cranially
  • Reduced lung fields (atelectasis)
  1. Ultrasound
  • Confirmed presence of liver lobes and intestines in thoracic cavity
  • Diaphragmatic discontinuity visualized

Loss of normal diaphragmatic line -Loops of gas-filled bowel visible within the thoracic cavity

Stomach and intestines exteriorized and liver can be seen inside the thoracic cavity

Liver is exteriorized

Hernia is sutured with the tube passing through to extract the remaining air

3 way stop catheter is used for faster air extraction

tube is removed and purse string around the tube closed immediately

X-Ray after one week ..

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