Related Experiment Videos
[Abdominal pain and vomiting: a 4-year old boy with relaxation of diaphragm]
M E Pragt-Weijer1, R J Thunnissen, Z J de Langen
1Afd. Kindergeneeskunde, Martini Ziekenhuis, Groningen.
Insights
A rare case of diaphragm relaxation in a child led to gastric volvulus and abdominal issues. Surgical repair of the diaphragm and organ repositioning resulted in a full recovery.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Thoracic Surgery
Background:
- Diaphragm relaxation, a rare condition, can be congenital or acquired.
- It is characterized by an intact but hypoplastic diaphragm, leading to an elevated diaphragm.
- Unlike congenital diaphragmatic hernia, the diaphragm remains anatomically intact.
Observation:
- A 4-year-old boy presented with vomiting, abdominal pain, and a left upper abdominal swelling.
- Symptoms included a week of general malaise and prolonged constipation.
- Radiological imaging showed a large air-fluid collection in the upper abdomen and chest.
Findings:
- Surgical exploration revealed gastric volvulus (twisting of the stomach).
- An elevated and hypoplastic diaphragm was identified as the cause.
- The intra-abdominal organs were displaced into the thoracic cavity.
Implications:
- Surgical plication of the diaphragm and repositioning of intra-abdominal organs successfully treated the condition.
- This case highlights the importance of recognizing diaphragm relaxation in pediatric patients with gastrointestinal and respiratory symptoms.
- Prompt surgical intervention can lead to excellent outcomes in cases of gastric volvulus secondary to diaphragm relaxation.
Abstract:
A 4-year-old boy presented with vomiting, abdominal pain and a visible swelling on the left side of the upper abdomen. He had been generally unwell for a week, and had been suffering from constipation for a longer period of time. Radiological examination revealed a large space containing air and fluid in the left side of the upper abdomen and the chest region. During surgery, gastric volvulus and an elevated diaphragm were found. Plication of the diaphragm was performed, and the intra-abdominal organs were replaced in their correct positions. Patient recovered well and remained without complaints. Diaphragm relaxation is rare, and can be either congenital or acquired. Unlike congenital diaphragmatic hernia, diaphragm relaxation is characterised by an elevated diaphragm which, although intact, is hypoplastic.