横隔膜ヘルニヤに合併した新生児胃穿孔性腹膜炎の1例
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概要
- 論文の詳細を見る
The patient was a male infant weighing 3,640 g who was born at full term in normal delivery. On the 3rd postnatal day he had vomiting, and on the following day there was marked abdominal distension. The heart sounds which had been heard on the left side at the time of birth were heard on the right side of the sternum to auscultation. Simple photography at upright posture revealed displacement of the heart to the right, pneumoperitoneum between the diaphragm and liver, and Niveau in the abdomen. By electro-cardiographic study, the condition was diagnosed not as dextrocardia but as marked displacement of the heart to the right, which was thought to be due to some sort of pressure from the left. So an X-ray film was taken with II. oblique projection, which revealed the presence of a hernia sac connecting with the diaphragm. Based on these findings, diaphragmatic true hernia associated with complicating acute peritonitis due to gastrointestinal perforation was diagnosed. The patient was instantly referred to surgery but died soon after the operation. Autopsy revealed postsurgical closure of true hernia in the anterosinistral portion of the tentorium of diaphragm and postsurgical closure of a large linear perforation at the posterior aspect of the corpus ventriculi. The absence of defects in the muscular layer of the gastric wall ruled out congenital deformity; as a catheter had not been used in nursing, the lesion was not traumatic. So it was attributed to incarceration of diaphragmatic hernia.
- 千葉大学の論文