왼쪽 횡격막 내장 전위에 의한 만성 반복 대장비만곡부염전 1예

김희선 ( Hee Sun Kim ),유정선 ( Jeong Seon Yoo ),한석주 ( Seok Joo Han ),박효진 ( Hyo Jin Park ) 대한소화기학회 2007 대한소화기학회지 Vol.49 No.1

The eventration of diaphragm is usually found incidentally on chest X-ray or sometimes presented as acute gastric volvulus. However, colonic volvulus on splenic flexure area complicated by diaphragmatic eventration is extremely rare. A 25 year old man complained of upper abdominal pain for three days. He had a history of brain injury during infant period, and had epilepsy and mental retardation. Plain chest X-ray showed left diaphragmatic eventration and marked dilatation of colon on splenic flexure area which had not been changed for last three years. Barium enema showed bird beak appearance on distal colon near the splenic flexure. Colonoscopic reduction failed. After decompression with rectal and nasogastric tubes, colonic volvulus was relieved. To prevent the recurrence of volvulus, we performed segmental resection of left colon including splenic flexure area and repaired the left diaphragmatic eventration. After the operation, the patient had no further recurrent episode of volvulus although ileus persisted. (Korean J Gastroenterol 2007;49:37-40)

저절로 파열된 횡경막 이완증 1예

이성철,김기홍,Lee, Seong-Cheol,Kim, Ki-Hong 대한소아외과학회 2000 소아외과 Vol.6 No.1

Spontaneous rupture of the eventrated diaphragm is not common. The authors report a case of spontaneous rupture of the congenital diaphragmatic eventration. An 8 year-old girl with right congenital diaphragmatic eventration and nephrotic syndrome was seen in emergency room because of severe abdominal pain and vomiting. She had intermittent abdominal pain for 1 year. Plain chest X-ray and ultrasonography showed entrapped bowels in the right thoracic area. Exploratory laparotomy revealed a ruptured right eventration. THE displaced abdominal viscera were repositioned into the abdominal cavity and the ruptured diaphragm was trimmed and plicated. The postoperative course was uneventful. Only one case of spontaneous rupture of eventrated diaphragmatic has been reported in the English literature.

횡격막성 내장전위에 동반된 장간막축형 급성 위염전 1예

김남일,이중현,이구,양창헌,이창우,배종대,정기훈,서정일 대한내과학회 2002 대한내과학회지 Vol.63 No.1

Acute gastric volvulus is extremely rare emergency surgical condition by abnormal rotation of stomach. It presents a puzzling picture which makes early diagnosis difficult, yet surgical interference must be accomplished early if life is to be saved. Gastric volvulus can be classified anatomically as organoaxial or mesenteroaxial. The symptoms triad of gastric volvulus are severe nausea with a paradoxical inability to vomiting, localized epigastric pain and impossibility of introducing a gastric tube. The diagnosis of it may be suspected on plain radiographic examination of the abdomen and symptoms, it is confirmed by specific findings on the upper gastrointestinal series. We experienced a case of mesenteroaxial type of acute gastric volvulus associated with diaphragmatic eventration. We treated this patient with reduction of volvulus, repair of diaphragmatic eventration, gastrojejunostomy and gastropexy. The authors report this case with a brief review of recent literatures.

횡경막 신경 차단 후 횡격막 위치 및 운동의 변화

최종범,김상수,양현웅,이삼윤,최순호 대한흉부외과학회 2002 Journal of Chest Surgery (J Chest Surg) Vol.35 No.10

Change of Diaphragmatic Level and Movement Following Division of Phrenic Nerve

선천성 가로막 이탈로 오인된 우측 가로막 내장탈출

김경수 ( Kyoung Soo Kim ),정재일 ( Jae Il Joung ),김정호 ( Jeong Ho Kim ),김봉성 ( Bong Seong Kim ),박기영 ( Kie Young Park ),이정주 ( Jung Joo Lee ),박종빈 ( Jong Bin Park ),최수정 ( Soo Jung Choi ) 대한주산의학회 2004 Perinatology Vol.15 No.2

Diaphragmatic eventration is an abnormal elevation of an intact diaphragm into the thoracic cavity as a result of paralysis, aplasia or atrophy of muscular fibers, which accounts for 5~10% of all diaphragmatic disorders. Congenital eventration result from a incomplete muscularization of the pleuroperitoneal membranes at 8~10 weeks` menstrual age, the cause of this failure is not known. Although some patients are asymptomatic and find out incidentally, significant compression of the affected chest contents can result in severe respiratory distress. The differentiation between congenital diaphragmatic eventration and congenital diaphragmatic hernia by sonography may be difficult, but important because of a significant differences in postnatal management and prognosis. We experienced a case of right congenital diaphragmatic eventration with severe respiratory distress during immediate postnatal period, who was initially diagnosed as congenital diaphragmatic hernia and performed plication at 18 hours after birth. So we report this case with review of literatures.

횡격막 이완증 2례

구광련,박춘호 朝鮮大學校 附設 醫學硏究所 1989 The Medical Journal of Chosun University Vol.14 No.2

Diaphragmatic eventration is a rare disease, congenital or acquired, abnormally high or elevated position of diaphragm as a result of paralysis, aplasia or atrophy of varying degree of the muscle fibers of the affected side with no break in the continuity of the muscle. We experienced two cases of diaphragmatic eventration with dyspnea and frequent respiratory disease. In physical examination there was noted decreased breathing sound on the affected lung field and bowel sound was audible. Diagnosis was done by chest X-ray and plication of the affected diaphragm was done in operation. Specific complications were not noted after surgical repair of diaphragmatic eventration with good result. We report two cases of diaphragmatic eventration with brief review of literatures.

횡경막 탈장으로 오인된 일측 선천성 횡경막 내장전위 1 예

양정인(Jeong In Yang),오기석(Kie Suk Oh),김행수(Haeng Soo Kim),이준서(June Seo Lee),홍정(Jeong Hong) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.1

Congenital diaphragmatic eventration is an abnormal elevation of the diaphragm as a result of developmental failure of muscular fibers during the fetal period. Mediastinal shift to the contralateral side may cause significant compression of the affected chest contents resulting in compromised pulmonary function especially when bilaterally involved. The differentiation between congenital diaphragmatic eventration and diaphragmatic hemia is very difficult but eventration has a better perinatal outcome compared to diaphragmatic hernia. We report a case of congenital diaphragmatic eventration on left side with good perinatal outcome after plication in which the initial prenatal diagnosis of diaphragmatic hernia was made by prenatal ultrasonography.

선천성 횡격막 거상증

신화균 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Eventration of the diaphragm is a rare anomaly. Severe respiratory distress in the newborn or neonate with a eventration of the diaphragm may be present because of secondary hypoplasia of the lung on the involved side. The diagnosis can be made in the majority of spontaneously breathing patients by chest roentgenography or by fluoroscopy. The treatment initially should be supportive, including assisted ventilation if needed. We describe the case of congenital eventraion with a brief review of the literature following these case reports, which was surgical plication.

선천성 횡경막 이완증

이상규,박동원,장수일,Lee, Sang-Kyu,Park, Dong-Weon,Chang, Soo-Il 대한소아외과학회 1998 소아외과 Vol.4 No.1

신생아 및 영아에서의 횡격막 이완증은 일반적으로 드문 질환으로 인식되어 있지만 이에 대한 정확한 진단과 적절한 원인별 처치의 필요성은 널리 알려진 사실이다. 최근 저자 등은 5 례의 선천성 횡격막 이완증을 경험할 수 있었고, 전 례 모두 수술이 적응되었다. 전 례 모두 생후 2개월 미만의 영아였고 모두 남아였다. 이완 부위는 전 예에서 좌측 횡격막이었다. 증상은 3례에서 호흡기 증상이 있었고 소화기계 증상은 없었으며 나머지 1례에서는 체중 증가불능 이 외는 무증상이었다. 전 예에서 방사선학적 변화가 저명하였고, 횡격막의 절정은 제 3에서 제 5늑간에 달하였다. 수술 술기로 저자 등은 경복부 접근 방법에 의한 횡격막 습벽 봉합술을 선호하였으며 수술 결과는 임상적으로나 방사선학적으로 우수하였다. Although diaphragmatic eventration in newborn infants is generally regarded as a rare condition, the need for accurate diagnosis and appropriate intervention according to the etiological factors is well known. Recently the authors experienced five consecutive cases of diaphragmatic eventration below the age of two months(one to 55 days) requiring surgery. All were in males, and were left sided. Respiratory symptoms were present in 4 patients, and one patient showed inability to gain weight. Diaphragms were elevated to the level of the third to fifth intercostal spaces. Diaphragmatic plication through the abdomen gave excellent results. There was no postoperative mortality.

Open Transthoracic Plication of the Diaphragm for Unilateral Diaphragmatic Eventration in Infants and Children

Yasser Mubarak,Ashraf Alshorbagy 대한흉부외과학회 2015 Journal of Chest Surgery (J Chest Surg) Vol.48 No.5

Background: To evaluate our experience of early surgical plication for diaphragmatic eventration (DE) in infancy and childhood. Methods: This study evaluated infants and children with symptomatic DE who underwent plication through an open transthoracic approach in our childhood development department between January 2005 and December 2012. Surgical plication was performed in several rows using polypropylene U-stitches with Teflon pledgets. Results: The study included 12 infants and children (7 boys and 5 girls) with symptomatic DE (9 congenital and 3 acquired). Reported symptoms included respiratory distress (91.7%), wheezing (75%), cough (66.7%), and recurrent pneumonia (50%). Preoperative mechanical ventilatory support was required in 41.7% of the patients. The mean length of hospital stay was 6.3±2.5 days. The mean follow-up period was 24.3±14.5 months. Preoperative symptoms were immediately relieved after surgery in 83.3% of patients and persisted in 16.7% of patients one year after surgery. All patients survived to the end of the two-year follow-up and none had recurrence of DE. Conclusion: Early diagnosis and surgical plication of the diaphragm for symptomatic congenital or acquired diaphragmatic eventration offers a good clinical outcome with no recurrence.