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Case Reports in Surgery Volume 2018 ,2018-12-06
Right Diaphragmatic Eventration with an Intrathoracic Kidney: Case Report and Review of the Literature
Case Report
Anibal Carrasco 1 Ricardo Castro 1
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DOI:10.1155/2018/2631391
Received 2018-08-24, accepted for publication 2018-11-25, Published 2018-11-25
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摘要

We aimed to review the publications on the diagnosis of diaphragmatic eventration and report on the clinical presentation and surgical treatment of a female patient aged 17 years. The present case, though quite infrequent, shows the presence of an ectopic thoracic kidney on the right side. The clinical features included dry cough, chest pain, respiratory distress, and bronchial spasms for 4 years; additionally, the patient had episodes of bronchial asthma since her childhood. The right hemithorax presented invasion of the thin loops, right colon, and kidney. The treatment approach was laparoscopic followed by thoracotomy using a dual mesh. The intrathoracic kidney remained in place. The outcome was satisfactory. Diaphragmatic eventration associated with thoracic renal ectopia is a very rare entity, considering the age, sex, and right location of the condition. It represents a clinical and diagnostic challenge; clinicians, radiologists, and surgeons must be alert with a high degree of suspicion in order to correlate symptoms and imaging findings and understand the etiopathogenesis. In addition, they should plan an adequate and individualized surgical repair making use, as far as possible, of the minimally invasive procedures that are currently used.

授权许可

Copyright © 2018 Anibal Carrasco and Ricardo Castro. 2018
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

图表

Axial section of both hemithoraces. Bowel loops occupying the right hemithorax.

Sagittal section of the right hemithorax showing occupation by intestinal loops and mesentery.

Axial section with the kidney in a posterior position and mild mediastinal compression.

Notable hepatic displacement towards the left hemiabdomen that causes gastric compression.

Sagittal section showing the occupation in a posterior situation of the kidney with the pedicle in the right hemithorax.

Contrast coronal section showing both hemithoraces. Lung parenchyma collapsed in the right hemithorax and occupied by the small intestine, right colon, mesentery, right kidney, and its corresponding pedicle. Normal left hemithorax.

The right kidney and its respective pedicle in the posterior intrathoracic situation.

Incision of the laminated and elongated hemidiaphragm with the presence of muscle fibers.

Suture of the hemidiaphragmatic defect. The kidney in the posterior view.

Mesh placement on the hemidiaphragm fixed in the anterolateral position. Note that it surrounds the kidney posteriorly since it remained in the intrathoracic position.

Postoperative radiological view of both hemithoraces, showing right lung expansion, renal silhouette, and the hemidiaphragmatic line. Central trachea and normal left hemithorax.

通讯作者

Anibal Carrasco.Department of General Surgery, Jorge Reategui Delgado Hospital, Av. Grau block 11 s/n, Piura, Peru, essalud.gob.pe.anibalfra@yahoo.es

推荐引用方式

Anibal Carrasco,Ricardo Castro. Right Diaphragmatic Eventration with an Intrathoracic Kidney: Case Report and Review of the Literature. Case Reports in Surgery ,Vol.2018(2018)

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