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KMID : 0371319680100060431
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Journal of the Korean Surgical Society
1968 Volume.10 No. 6 p.431 ~ p.435
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Congenital Diaphragmatic Anomalies
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李世淳/Lee, S.S.
金義烈/金光洙/崔厦景/徐相賢/洪弼勳/Kim, I.Y./Kim, G.S./Choi, H.K./Suh, S.H./Hong, P.W.
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Abstract
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Congenital diaphragmatic anomaly is one of the surgical emergencies, especially in new born and infant, because the most of the anomalies accompany the herniation of the intra-abdominal viscera into the pleural cavity ensuing cardipulmonary embarrassment. A review of the literature, even in recent years, showed high mortality of this anomaly if left untreated. The purpose of this paper is to present author´s experience with six cases of the congenital diaphragmatic anomalies which were treated surgically during last six-year period, along with the review of embryology and pathological anatomy of this condition.
Among the six cases of the congenital diaphragmatic anomalies there was one case of left sided posterolateral hernia (Bochdalek type), one agenesis or central tendinous portion of right hemidiaphragm, three esophageal hiatal sliding hernia and one eventration of left diaphragm. All cases of the hiatal hernia occurred after the patients had grown, and the remainders in the new born and infants. All lesions were repaired by thoracic approaches except two cases of hiatal hernia which were approached by thoracoabdominal incision.
Both the Bochdalek hernia and agenesis of the diaphragm showed associated pulmonary hypoplasia of varying degree, and it was so great that the lung was incapable of supporting extrauterine life in later case, who died on the table during operation. The case of Bochdalek hernia suddenly died of unknown origin 2 months after discharge. All of hiatal hernia had good result nevertheless one of which had been associated with volvulus of the stomach in mesenterioaxis. The eventration of the diaphragm was treated by plication and the chest X-ray 2 years later showed good mainenance of plicated diaphragm in normal level.
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