Congenital hemidiaphragmatic agenesis presenting as reversible mesenteroaxial gastric volvulus and diaphragmatic hernia: a case report.
A 70-yr-old woman complained of left sided chest pain and non-bilious vomiting for four days after taking a gastric bloating agent for an upper gastrointestinal study. The chest radiography revealed gastric air-fluid levels and bowel loops in the left thoracic cavity. An emergency thoracotomy was performed. The abdominal organs (stomach, spleen, splenic flexure of the colon) were in the left thorax and the entire left hemidiaphragm was absent. There were no diaphragmatic remnants visible for reconstruction of the left diaphragm. We provided warm saline irrigation and performed a left lower lobe adhesiotomy. Thirteen days after surgery, the chest radiography showed improvement in the herniation but mild haziness remained at the left lower lung field. Here we present the oldest case of congenital diaphragmatic agenesis presenting with transient gastric volvulus and diaphragmatic hernia.
Sung
Hye Young
HY
Division of Gastroenterology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.
Cho
Se Hyun
SH
Sim
Sung Bo
SB
Kim
Jin Il
JI
Cheung
Dae Young
DY
Park
Soo-Heon
SH
Han
Joon-Yeol
JY
Lee
Se Min
SM
Noh
Chee Ho
CH
Park
Yong-Bum
YB
Jung
Seung Eun
SE
Lee
Seon Hui
SH
Choi
Kyu Yong
KY
D000368:Aged; D003937:Diagnosis, Differential; D003964:Diaphragm / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006548:Hernia, Diaphragmatic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D013277:Stomach Volvulus / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed