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Normothermic Negative Pressure Ventilation Ex Situ Lung Perfusion: Evaluation of Lung Function and Metabolism
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Published on: February 14, 2022

A sternotomy too far.

Khaled Ashour1, Katharine Jamieson, Kokila Lakhoo

  • 1Department of Paediatric Surgery, John Radcliffe Hospital, Oxford University, Headley Way, Headington, Oxford, OX3 9DU, UK. Khaled.Ashour@orh.nhs.uk

Interactive Cardiovascular and Thoracic Surgery
|July 22, 2009
PubMed
Summary

Median sternotomy, a standard pediatric cardiothoracic approach, can rarely lead to iatrogenic diaphragmatic hernia. This case report details such an instance in a 14-month-old boy, highlighting a previously unreported complication.

Area of Science:

  • Pediatric surgery
  • Thoracic surgery
  • Surgical complications

Background:

  • Median sternotomy is a widely adopted surgical approach for pediatric cardiothoracic procedures.
  • While generally safe, various complications associated with median sternotomy have been documented.
  • Iatrogenic diaphragmatic hernia has not been previously recognized as a complication of this procedure.

Observation:

  • This report details a rare case of a 14-month-old male infant.
  • The infant developed an iatrogenic diaphragmatic hernia.
  • The complication occurred subsequent to undergoing a median sternotomy procedure.

Findings:

  • The case presents the first documented instance of iatrogenic diaphragmatic hernia following pediatric median sternotomy.

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  • This finding expands the spectrum of known complications associated with this surgical approach.
  • The report underscores the importance of vigilance for rare complications even with standard procedures.

    • Implications:

    • This case suggests that iatrogenic diaphragmatic hernia should be considered in the differential diagnosis of postoperative complications after pediatric median sternotomy.
    • Further investigation may be warranted to understand the mechanism and incidence of this complication.
    • Clinicians should be aware of this potential risk when performing and managing patients undergoing median sternotomy.