ABSTRACT
Three cases of retrosternal diaphragmatic hernia (Morgagni hernia) are reported. Diagnosis have been made by conventional radiology (Chest X-ray, Upper G-I series) in 2 cases: the third one was found incidentally during a laparotomy. Peritoneography, CT scan, NMR are recommended in the difficult cases. ONe case presented as acute gastric outlet obstruction secondary to an intra-thoracic volvulus of the herniated stomach. Surgical treatment is indicated in all cases of retrosternal diaphragmatic hernia because of the high-risk of complications (gastric volvulus, colonic obstruction). Surgery through an abdominal approach is preferred and post-operative course is benign.
Subject(s)
Colonic Diseases/etiology , Hernia, Diaphragmatic/complications , Intestinal Obstruction/etiology , Stomach Volvulus/etiology , Adult , Aged , Female , Hernia, Diaphragmatic/diagnosis , Hernia, Diaphragmatic/surgery , Humans , Male , Middle AgedSubject(s)
Hemangioma/diagnosis , Kidney Neoplasms/diagnosis , Lipoma/diagnosis , Adult , Female , Humans , NephrectomyABSTRACT
The authors report 2 new cases of acute necrosis of the colon without vascular obstruction and reviewed them in the light of 94 similar cases collected in the literature. Such lesions of colonic necrosis are believed to be the final outcome of a variable combination of functional circulatory disturbances and of infections starting in the colonic mucosa. Total excision of lesions offers the best chance of recovery. It would seem that the extent of lesions of the mucosa can be determined only by per-operative colonoscopy, findings being used to determine the limits of the resection carried out. There otherwise arises the question of the legitimacy of extensive colonic incision (sub-total or total colectomy with sometimes resection of the rectum) because of the constant possibility of secondary progression of mucosa lesions left in place. The prognosis in this condition is very serious since mortality of cases having undergone potentially curative surgery remains at 56%.
Subject(s)
Colonic Diseases/complications , Intestinal Obstruction/complications , Necrosis/complications , Acute Disease , Aged , Colectomy , Colon/blood supply , Colonic Diseases/pathology , Colonic Diseases/physiopathology , Colonic Diseases/surgery , Humans , Male , Middle Aged , Necrosis/pathology , Necrosis/physiopathology , PrognosisABSTRACT
Hydatid cyst of the pancreas is rare since it accounts for less than 1% of the various sites of hydatid disease even in those countries where the latter is endemic. The diagnosis is rarely made before surgery but is currently facilitated by ultrasonography and CAT scan. The authors report 3 cases, including one with a cyst ruptured into the peritoneal cavity.