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Intrapericardial diaphragmatic hernia in adults.

R L Meng, A Straus, F Milloy

    Annals of Surgery
    |March 1, 1979
    PubMed
    Summary
    This summary is machine-generated.

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    Intrapericardial diaphragmatic hernia (IDH) is a rare condition where abdominal organs protrude into the heart sac, often due to trauma. Prompt surgical repair is crucial for recovery and to prevent life-threatening complications.

    Area of Science:

    • Thoracic surgery
    • Gastroenterology
    • Trauma surgery

    Background:

    • Intrapericardial diaphragmatic hernia (IDH) is an exceptionally rare congenital or acquired condition in adults.
    • This abstract reviews 28 reported cases, highlighting its rarity and diverse etiologies, primarily blunt trauma.

    Observation:

    • Patients presented with symptoms ranging from intermittent bowel obstruction to cardiac dysfunction, including dyspnea, palpitations, and cardiac tamponade.
    • Physical findings included abnormal chest auscultation and radiographic evidence of abdominal contents within the chest.
    • Diagnostic tools like chest roentgenography, barium studies, and pneumoperitoneum fluoroscopy are essential.

    Findings:

    • IDH can manifest acutely or years after initial trauma.
    • Symptoms are often non-specific, mimicking other gastrointestinal or cardiac conditions.

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  • Diagnosis requires a high index of suspicion and comprehensive imaging.

    • Implications:

    • Early diagnosis and surgical intervention (celiotomy) are vital for managing incapacitating or life-threatening symptoms.
    • Surgical repair offers a favorable prognosis with a low recurrence rate.
    • Increased awareness and diagnostic vigilance are necessary for this rare diaphragmatic hernia.