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[Incarcerated diaphragmatic hernia presenting as colonic obstruction]
Y Moses1, S Sapoznicov, Y Manoskin
1Dept. of General and Vascular Surgery, Barzilai Medical Center, Ashkelon.
Harefuah
|July 26, 2000
Summary
Rare adult diaphragmatic hernias, excluding hiatal hernias, often present with gastrointestinal complications like colonic incarceration. Increased awareness is key for timely diagnosis and treatment of these thoraco-abdominal emergencies.
Area of Science:
- General Surgery
- Thoracic Surgery
- Gastroenterology
Background:
- Diaphragmatic hernias are rare in adults, unlike common hiatal hernias.
- Congenital diaphragmatic hernias typically present in infants with severe respiratory distress.
Observation:
- This study details three adult male cases of non-hiatal diaphragmatic hernias.
- Two cases involved colonic incarceration with strangulation; one was an incidental finding during trauma evaluation.
Findings:
- Adult diaphragmatic hernias predominantly manifest with gastrointestinal complications, contrasting with infant presentations.
- Clinical presentation in adults includes incarcerated or strangulated colon within the hernia.
Implications:
- High awareness of adult diaphragmatic hernias, potentially recurrent from perinatal repair, is crucial for effective treatment.
- Management requires a combined thoraco-abdominal approach, often involving simultaneous laparotomy, thoracotomy, and stoma formation.