Left diaphragmmatic eventration with gastric volvulus: Laparoscopic mesh repair of left diaphragmatic eventration

Lakshmikanth T, Sanjeeva Rao K

Pdf Page Numbers :- 69-73

Lakshmikanth T^1,* and Sanjeeva Rao K¹

¹Department of Surgical Gastroenterology, Krishna Institute of Medical Sciences, Minister Road, Secunderabad - 500003, AP, India

*Corresponding author: Dr. Lakshmikanth T, MS, FIGS(KMC, JAPAN), FSGE(NIMS), FLS, Consultant Surgical Gastroenterologist, Krishna Institute of Medical Sciences, Minister Road, Secunderabad - 500003, AP, India.

Received 10 May 2012; Revised 28 May 2013; Accepted 10 June 2013

Citation: Lakshmikanth T, Sanjeeva Rao K. Left diaphragmmatic eventration with gastric volvulus: Laparoscopic mesh repair of left diaphragmatic eventration. J Med Sci Res 2013; 1(2): 69-73. http://dx.doi.org/10.17727/JMSR.2013/1-013

Copyright: © 2013 Lakshmikanth T et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Background: Eventration of diaphragm is defined as an abnormal elevation of an intact diaphragm and most often is characterized by a developmental abnormality of the diaphragm musculature. It usually remains asymptomatic in early life and presents later with respiratory and gastrointestinal complications. It is also seen in acquired conditions like phrenic nerve dysfunction in old age. Material and methods: A 64 yr man came with abdominal discomfort and fullness with nonbilous intermittent vomitings for 20days and unable to take food. Chest roentgenogram revealed an elevated left hemidiaphragm and a shift of the lower mediastinum to right. Barium study showed gastric volvulus. CT scan showed eventration of left dome of diaphragm with gastric volvulus. Results: The procedures were performed laparoscopically and follow up showed excellent results. Patient recovered well with symptomatic relief. Conclusion: All cases of diaphragmatic eventration do not require surgical intervention if it is not associated with adverse symptoms. However treatment of laparoscopic mesh repair by abdominal approach is indicated if it is symptomatic. Laparoscopic approach has become an attractive alternative because of its association with less postoperative pain and better cosmesis.

Keywords: Gastric volvulus; Left diaphragmatic eventration; Laproscopic mesh repair