Journal of Indian Association of Pediatric Surgeons Medknow Publications on behalf of the Indian Association of Pediatric Surgeons ISSN: 0971-9261 EISSN: 1998-3891 Vol. 11, Num. 1, 2006, pp. 51-52

Journal of Indian Association of Pediatric Surgeons, Vol. 11, No. 1, January-March, 2006, pp. 51-52

Images

MRI in central diaphragmatic hernia with intrapericardial herniation

C. R. Thambidorai, A. Zulfiqar¹, J. Rohana², S. Venayagamurthy

Paediatric Surgery Unit, Departments of Surgery, ¹Radiology and ²Neonatology, Hospital University Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
Correspondence Address:C. R. Thambidorai, Paediatric surgery unit, Department of Surgery, Hospital University Kebangsaan Malaysia, Jalan Yaacob Latiff, Cheras, 56000, Kuala Lumpur, Malaysia. E-mail: tdorai@pc.jaring.my

Code Number: ip06013

A ten-month old male infant presented with recurrent cough. Chest radiograph [Figure - 1] showed bowel shadows in the left hemithorax with elevation of the inferior border of the heart. Ultrasound (US) revealed herniation of the liver and pericardial effusion [Figure - 2]. Magnetic resonance imaging (MRI) [Figure - 3][Figure - 4] showed the intrapericardial herniation and the extent of the central tendon defect (CTD). The findings were confirmed at surgery. The use of MRI in the diagnosis of CH in infants has not been reported before.

In central hernia (CH) of the diaphragm, herniation occurs through a CTD, mainly into the pericardial cavity and left hemithorax.[1] The pericardial effusion in CH may be the result of pericardial irritation.[1] The limited suprahepatic space often hinders the correct definition of the CTD at surgery. Preoperative MRI ensures the use of appropriate incision, protection of inferior vena cava and hepatic veins at surgery and the adequacy of hernia repair.

References

Copyright 2006 - Journal of Indian Association of Pediatric Surgeons

The following images related to this document are available:

Photo images