Skip to main content

Advertisement

Log in

ePTFE soft tissue patch reconstruction of hemidiaphragmatic agenesis with late clinical presentation

  • Case Report
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

In this paper we describe a case of a 71-year-old man affected by left hemidiaphragm agenesis who presented an extensive enterothorax after an asymptomatic history for many years. The patient had late development of severe constipation and occasional episodes of bowel obstruction and vomiting. The surgical correction of this congenital anomaly consisted of restoring the continuity of the diaphragmatic barrier with a 2-mm-thick expanded polytetrafluoroethylene soft tissue patch(Gore-Tex®) after the herniated viscera have been replaced into the abdominal cavity. At 26 months' follow-up no recurrence has been observed. We would suggest that this is the first known elderly patient surgically treated and the eighth case reported in the literature. The use of a single-layer ePTFE mesh allows a good anatomical and functional repair. An overview of the literature is also reported.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Singh G, Bose SM (1993) Agenesis of hemidiaphragm in adults. Aust NZ J Surg 63:327–328

    Article  CAS  Google Scholar 

  2. Tsang TM, Tam PKH, Dudley NE, Stevens J (1995) Diaphragmatic agenesis as a distinct clinical entity. J Pediatr Surg 30:16–18

    Article  PubMed  CAS  Google Scholar 

  3. Tzelepis GE, Ettensohn DB, Shapiro B, McCool FD (1988) Unilateral absence of the diaphragm in an asymptomatic adult. Chest 94:1301–1303

    Article  PubMed  CAS  Google Scholar 

  4. Travaline JM, Cordova F (1996) Agenesis of the diaphragm. Am J Med 100:585

    Article  PubMed  CAS  Google Scholar 

  5. Glavaš M, Dražinić I, Pikot D, Altarac S (2000) Patch reconstruction of hemidiaphragm agenesis by the polypropylene mesh prosthesis. Croat Med J 41:333–335

    PubMed  Google Scholar 

  6. Sheehan JJ, Kearns SR, McNamara DA, Brennan RB, Deasy JM (2000) Adult presentation of agenesis of the hemidiaphragm. Chest 117:901–902

    Article  PubMed  CAS  Google Scholar 

  7. Anderson CD, Eliason J, Roberts JR, Sharp KW (2003) Bilateral diaphragmatic agenesis in an adult complicated by a paraduodenal hernia. Am Surg 69:523–525

    PubMed  Google Scholar 

  8. Muraskas JK, Husain A, Myers TF, Anderson CL, Blak PR (1993) An association of pulmonary hypoplasia with unilateral agenesis of the diaphragm. J Pediatr Surg 28:999–1002

    Article  PubMed  CAS  Google Scholar 

  9. Menezes SLS, Chagas PSC, Macedo-Neto AV, Santos VCT, Rocco PRM, Zin WA (2000) Suture or prosthetic reconstruction of experimental diaphragmatic defects. Chest 117:1443–1448

    Article  PubMed  CAS  Google Scholar 

  10. Atkinson JB, Poon MW (1992) ECMO and the management of congenital diaphragmatic hernia with large diaphragmatic defects requiring a prosthetic patch. J Pediatr Surg 27:754–756

    Article  PubMed  CAS  Google Scholar 

  11. Topart P, Ferrand L, Vandenbroucke F, Lozac’h P (2005) Laparoscopic ventral hernia repair with the goretex dualmesh: long-term results and review of the literature. Hernia 9:348–352

    Article  PubMed  Google Scholar 

  12. Law NH, Ellis H (1988) Adhesion formation and peritoneal healing on prosthetic materials. Clin Mater 3:95–101

    Article  Google Scholar 

  13. Murphy JL, Freeman JB, Dionne PG (1989) Comparison of marlex and gore-tex to repair abdominal wall defects in the rat. Can J Surg 32:244–247

    PubMed  CAS  Google Scholar 

  14. Matthews BD, Mostafa G, Carbonell AM, Joel CS, Kercher KW, Austin C, Norton HJ, Heniford BT (2005) Evaluation of adhesion formation and host tissue response to intraabdominal polytetrafluoroethylene mesh and composite prosthetic mesh. J Surg Res 123:227–234

    Article  PubMed  CAS  Google Scholar 

  15. Isaka M, Nishibe T, Okuda Y, Saito M, Seno T, Yamashita K, Izumisawa Y, Kotani T, Yasuda K (2006) Experimental study on stability of a high-porosity expanded polytetrafluoroethylene graft in dogs. Ann Thorac Cardiovasc Surg 12:37–41

    PubMed  Google Scholar 

  16. McGinty JJ, Hogle NJ, McCarhy H, Fowler DL (2003) A comparative study of adhesion formation and abdominal wall in-growth after laparoscopic ventral hernia repair in a porcine model using multiple types of mesh. Surg Endosc 19:786–790

    Article  Google Scholar 

  17. Klinge U, Klosterhalfen B, Müller M Schumpelick V (1999) Foreign body reaction to meshes used for the repair of abdominal wall hernias. Eur J Surg 165:665–673

    Article  PubMed  CAS  Google Scholar 

  18. Klosterhalfen B, Junge K, Klinge U (2005) The lightweight and large porous mesh concept for hernias repair. Expert Rev Med Devices 2:103–107

    Article  PubMed  Google Scholar 

  19. Williams SK, Patula VB, Kleinert LB, Martakos P, Lane JP, Karwoski T (2005) Dual porosity expanded polytetrafluoroethylene for soft-tissue augmentation. Plast Reconstr Surg 115:1995–2006

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to L. Fei.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fei, L., Saviano, C., Moccia, F. et al. ePTFE soft tissue patch reconstruction of hemidiaphragmatic agenesis with late clinical presentation. Hernia 12, 103–106 (2008). https://doi.org/10.1007/s10029-007-0254-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-007-0254-z

Keywords

Navigation