Topic 36 of 74 in the MU Plovdiv syllabus for Special Surgery (Medicine, Year 4). The free AceMed note covers it in 24 sections, about 1,021 words (9 min of reading), with 15 flashcards.
In this note
Which side of the diaphragm is more prone to injury and why?
Which are the most common abdominal organs that herniated through the diaphragmatic defect in cases of the left sided diaphragmatic ruptures?
THEME X: THE DIAPHRAMATIC HERNIAS
The diaphragm is a musculotendinous septum that separates the thoracic from the abdominal cavity. It consists of three components, which are typically separated from each other by muscle-free gaps. Which are these components?
What is the definition of “Bochdalek’s gap”?
What is the definition of “Morgagni’s gap” and “Larrey’s gap”?
What does “Bochdalek hernia” mean?
What does “Morgagni’s hernia” mean?
Which is the most common type of diaphragmatic hernia in adults?
Three types of hiatal hernia have been described. Which are they?
Which is the most common type of hiatal hernia?
Which symptoms are most commonly established in patients with a sliding hernia?
Which is the most common symptom in patients with hiatal hernia type II?
Which type of hiatal hernia can cause acute life-threatening events?
What is the clinical presentation of gastric torsion or volvulus in type II and III of hiatal hernias?
What is the management of hiatal hernia type II and III?
What is the general principle in the management of sliding hiatal hernias?
Which are the general principles in operative treatment of hiatal hernias?
Which is the most important diagnostic test in hiatal hernia?
Which condition most commonly mimics the radiographic features of herniation through the foramen of Morgagni adults?
Definition of diaphragmatic hernia? (other source)
Types of diaphragmatic hernias according to the localisation of hernial ring?
Which type of hiatal hernia is indicated for operative treatment, after its diagnosis?
Hiatal hernia - types, which one is most dangerous and why
Which side of the diaphragm is more prone to injury and why?
The left side of the diaphragm is more prone to injury (65-85% of cases)
Because it is not protected by the liver.
The left posterolateral portion of the diaphragm is the weakest, and therefore the most common site of rupture and herniation.
Which are the most common abdominal organs that herniated through the diaphragmatic defect in cases of the left sided diaphragmatic ruptures?
The most common abdominal organs that herniate through the left side diaphragmatic defect are
➊ Colon
➋ Stomach
➌ Small bowel
➍ Spleen
Clinical Features
The diaphragm is a musculotendinous septum that separates the thoracic from the abdominal cavity. It consists of three components, which are typically separated from each other by muscle-free gaps. Which are these components?
The three components of diaphragm are:
I. Costar ( pars costalis)
II. Lumbar (pars lumbalis)
III. Sternar (sternalis)
They all insert at the central tendon.
What is the definition of “Bochdalek’s gap”?
Whit Bochdalek’s gap is noted lumbocostal triangle (trigonum lumbocostale).
It is a triangle of the diaphragm with lacking muscle fibers that exists posteriorly between the lumbar and costal parts of the diaphragm.
In these weak areas the gap is usually closed only by the pleura, peritoneum and fascia (Trasversalis & phrenicopleuralis ).
The Bochdalek gaps are loci minoris resistentiae and therefore could be the site of development of congenital or acquired transdiaphragmatic hernias.
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