Diaphragmatic Hernia following Pediatric Liver Transplantation: An Underappreciated Complication Prone to Recur
| Autor: | Joseph F. Magliocca, Oliver J. Muensterer, Florian W. R. Vondran, Markus Guba, Hector Vilca-Melendez, Nicolas Richter, Michael Berger, Miriam Cortes Cerisuelo, Lea Sibylle Waldron, Blayne Amir Sayed, Eberhard Lurz, Dietrich von Schweinitz, Denise Lo, Ulrich Baumann |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Nausea medicine.medical_treatment 030230 surgery Liver transplantation Asymptomatic 03 medical and health sciences 0302 clinical medicine Postoperative Complications Recurrence medicine Humans Diaphragmatic hernia Child Retrospective Studies Surgical repair Hernia Diaphragmatic Respiratory distress business.industry Infant medicine.disease Surgery Liver Transplantation Child Preschool Pediatrics Perinatology and Child Health Vomiting 030211 gastroenterology & hepatology medicine.symptom business Complication |
| Zdroj: | European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie. 31(5) |
| ISSN: | 1439-359X |
| Popis: | Introduction Postoperative diaphragmatic hernia (DH) is a rare but potentially life-threatening complication following pediatric liver transplantation (LT). In the current literature, a total of 49 such hernias have been reported in 17 case series. We present eight additional cases, three of which reoccurred after surgical correction, and review the current literature with a focus on recurrence. Materials and Methods The study sample included children ( Results For the eight children with DH, the mean age at LT was 28.0 (5–132) months. All patients with a DH received left lateral segment split grafts except one, who received a full left lobe. The mean weight at time of LT was 11.8 (6.6–34) kg. Two patients had a primary abdominal muscle closure, and six had a temporary silastic mesh closure. All eight children presented with a right posterolateral DH. The small bowel was herniated in the majority of cases. Symptoms reported included nausea, vomiting, and respiratory distress. Two patients were asymptomatic, and discovery was incidental. All patients underwent prompt primary surgical repair. Three DH hernias (37.5%) recurred despite successful surgical correction. Conclusion DH following liver transplant with technical variant grafts may be underreported and is prone to recur despite surgical correction. A better understanding of the pathophysiology and more thorough reporting may help increase awareness. Early detection and prompt surgical management are the cornerstones of a successful outcome. |
| Databáze: | OpenAIRE |
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