新生児Morgagniヘルニアの治験例 : 12ヵ月未満本邦報告例の検討

概要

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A neonate with hepatic herniation through the foramen of Morgagni was reported. On the 6th day after birth, the baby was transferred to our neonatal ICU because of severe cynosis and tachypnea with a large mass occupying right hemithorax in a chest x-ray film. The baby was operated upon at age 35 days and a hepatic herniation through the foramen of Morgagni was found. In this case, the sac which contained a part of the right lobe of the liver of embriological shape measuring, 5×7 cm in size protruded into the pleural cavity com-pressing the right atrium and ventricle. The defect of the diaphragm was directly closed and reinforced with a Dacron velour patch. The postoperative course was uneventful. The value of PO_2 was improved but still remained al the lower level. In the postoperative perfusion scan of the lung, R-L shunt through Patent Foramen Ovale was found in spite of the decom-pression of the heart and lung. One of the reasons for the lower PO_2 may be ascribed to immaturity of the pulmonary vascular bed and alveoli, seen in Bochdalek hernia. The patient is currently well 2 years after the repair of hernia with minimal or without detectable pulmonary sequalae. He is classified as the late gestation or neonatal acquired congenital diaphragmatic hernia.
日本小児外科学会の論文
1985-06-20