diaphragmatic hernia (redirected from Hernia, diaphragmatic)

hernia /her·nia/ (her´ne-ah) [L.] protrusion of a portion of an organ or tissue through an abnormal opening.her´nial

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abdominal hernia  one through the abdominal wall, either a congenital defect or a complication of pregnancy or a surgical incision.

Barth hernia  one between the serosa of the abdominal wall and that of a persistent vitelline duct.

Béclard's hernia  femoral hernia at the saphenous opening.

Bochdalek hernia  congenital diaphragmatic hernia through the pleuroperitoneal hiatus.

cerebral hernia  protrusion of brain substance through the cranium.

Cloquet's hernia  pectineal h.

complete hernia  one in which the sac and its contents have passed through the hernial orifice.

congenital diaphragmatic hernia  one due to failure of a foramen in the fetal diaphragm to close when the infant is born; abdominal viscera in the thoracic cavity may cause fatal respiratory failure.

diaphragmatic hernia  hernia through the diaphragm.

diverticular hernia  protrusion of a congenital diverticulum of the intestine.

epigastric hernia  a hernia through the linea alba above the navel.

extrasaccular hernia  sliding h.

fat hernia  hernial protrusion of peritoneal fat through the abdominal wall.

femoral hernia  protrusion of a loop of intestine into the femoral canal.

gastroesophageal hernia  paraesophageal h.

Hesselbach's hernia  femoral hernia with a pouch through the cribriform fascia.

hiatal hernia , hiatus hernia protrusion of any structure through the esophageal hiatus of the diaphragm.

Holthouse's hernia  an inguinal hernia that has turned outward into the groin.

incarcerated hernia  a hernia so occluded that it cannot be returned by manipulation; it may or may not be strangulated.

incisional hernia  one through an old abdominal incision.

inguinal hernia  hernia into the inguinal canal.

intermuscular hernia , interparietal hernia an interstitial hernia lying between one or another of the fascial or muscular planes of the abdomen.

interstitial hernia  one in which a knuckle of intestine lies between two layers of the abdominal wall.

intra-abdominal hernia  congenital malpositioning of the intestine within the abdomen, with a portion of it protruding through a defect in the peritoneum or being trapped in a sac of peritoneum.

ischiatic hernia  sciatic h.

labial hernia  one into a labium majus.

mesocolic hernia  paraduodenal h.

obturator hernia  one protruding through the obturator foramen.

omental hernia  an abdominal hernia containing omentum.

ovarian hernia  hernial protrusion of an ovary.

paraduodenal hernia  an intra-abdominal hernia in which the small intestine rotates incompletely during development and becomes trapped in the mesentery of the colon.

paraesophageal hernia  hiatal hernia in which the esophagogastric junction is in place and a small or large part of the stomach protrudes into the thorax.

pectineal hernia  a femoral hernia that enters the femoral canal and then perforates the aponeurosis of the pectineus muscle.

perineal hernia  herniation of intestine into the perineum through a fissure in the levator muscle and its fascia.

preperitoneal hernia , properitoneal hernia an interstitial hernia lying between the parietal peritoneum and the transverse fascia.

reducible hernia  one that can be returned by manipulation.

retrograde hernia  herniation of two loops of intestine, with the part between them being within the abdominal wall.

Richter's hernia  incarcerated or strangulated hernia in which only part of the circumference of the bowel wall is involved.

sciatic hernia  herniation of intestine through the greater or lesser sciatic foramen.

scrotal hernia  inguinal hernia that has passed into the scrotum.

sliding hernia  hernia of the cecum (on the right) or the sigmoid colon (on the left) in which the intestinal wall forms part of the hernial sac and the rest of the sac is formed by parietal peritoneum.

sliding hiatal hernia  hiatal hernia with the upper stomach and the esophagogastric junction protruding into the posterior mediastinum; the protrusion may be fixed or intermittent and is partially covered by a peritoneal sac.

strangulated hernia  incarcerated hernia so tightly constricted as to compromise the blood supply of the hernial sac, leading to gangrene of the sac and its contents.

synovial hernia  protrusion of the inner lining membrane through the fibrous membrane of an articular capsule.

umbilical hernia  an abdominal hernia with intestine inside the umbilicus and the body wall defect and protruding intestine covered by skin and subcutaneous tissue.

hernia u´teri inguina´lis  see persistent müllerian duct syndrome, under syndrome.

vaginal hernia  vaginocele; a hernia into the vagina.

ventral hernia  abdominal h.

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diaphragmatic hernia

n.

The protrusion of abdominal parts, such as the stomach and small intestine, into the chest through a weakness in the diaphragm. Also called diaphragmatocele.

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diaphragmatic hernia

Etymology: Gk, diaphragma, partition; L, rupture

the protrusion of part of the stomach through an opening in the diaphragm, most commonly an abnormally enlarged esophageal hiatus. In some cases the intestines may also herniate into the chest. The enlargement of the normal opening for the esophagus may be caused by trauma, congenital weakness, increased abdominal pressure, or relaxation of ligaments of skeletal muscles, and it permits part of the stomach to slide into the thorax. A sliding hiatal hernia, one of the most common pathologic conditions of the upper GI tract, may occur at any age but is most prevalent in elderly and middle-aged people. A kind of diaphragmatic hernia is hiatal hernia.

observations Symptoms of diaphragmatic hernia vary but usually include heartburn after meals, when the patient is in a supine position, and on exertion, especially when bending forward. Regurgitation of food, dysphagia, abdominal distention after eating, belching, intestinal rumbling, rapid breathing, and a dull epigastric pain radiating to the shoulder may occur. The similarity of some of the symptoms to those of myocardial infarction may make the patient fearful and anxious. Continued reflux of gastric juice into the esophagus may lead to ulceration with bleeding and the formation of fibrous tissue. Gastric contents regurgitated during sleep may be aspirated into the lungs.

interventions The patient is placed in bed in a semi-Fowler's position and raised to a high Fowler's position during and after small, frequent meals of a bland diet. The individual is encouraged to chew slowly and thoroughly, to drink one or two glasses of water with a meal (unless contraindicated), and to avoid smoking. The blood pressure, pulse, respirations, and temperature are monitored. Medication for pain, an antacid such as aluminum hydroxide gel, and diagnostic endoscopy and x-ray films may be ordered. To facilitate visualization of the hernia, the patient may be placed in a Trendelenburg position during studies of barium swallowing. If symptoms are severe, persistent, and unrelieved by conservative measures, the hernia may be repaired surgically.

nursing considerations The patient is instructed, before discharge, to eat frequent, small bland meals; not to recline after eating; to lose weight (if indicated); not to smoke; and to avoid constipation. The patient may need to sleep with the head of the bed raised on blocks. Recurrence of symptoms may usually be prevented by observing these instructions.

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diaphragmatic

pertaining to the diaphragm.

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diaphragmatic abscess

in the cow produces a syndrome of humped back, pain on percussion over the xiphoid area, fever and leukocytosis.

diaphragmatic hernia

in cattle, cases resulting from traumatic reticulitis show chronic ruminal tympany, distention, emaciation, anterior displacement of the heart with systolic murmur. Congenital cases in calves and those in cows due to trauma show dyspnea, displacement of the heart, and gut sounds audible in the chest. Horse cases are usually traumatic in origin and result in an acute onset of severe colic with no good distinguishing signs. In dogs and cats, uncommonly congenital but a common sequela to trauma with signs of dyspnea and pleural effusion. See also peritoneopericardial hernia.

diaphragmatic rupture

see diaphragmatic hernia (above).

diaphragmatic septal defects

include pleuroperitoneal and pericardioperitoneal defects.

synchronous diaphragmatic flutter

violent, unilateral hiccoughs occur with each heartbeat, sometimes with muscle tetany reminiscent of lactation tetany; some cases of that disease also have flutter. Acid-base imbalance is present in most cases. Recovery is spontaneous and following treatment with calcium solutions.

diaphragmatic tendon

the heart-shaped tendinous center of the diaphragm.

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diaphragmatic hernia

A common–1:2000 live births congenital defect in which a loop of bowel passes through the diaphragm, due to a defective closure of the pleuroperitoneal membrane–through the foramen of Bochdalek, resulting in a common cavity, with the abdominal organs–usually left-sided prolapsing into the chest cavity, which compromises respiration; permutations of DH may be discovered later in life–eg, parasternal hernias or membranous defects; less common sites of DH–through esophageal hiatus or Morgagni's foramen Treatment Surgical repair, ventilatory support and bicarbonates Mortality 40%