Year 2020, Volume 4 , Issue 11, Pages 1089 - 1091 2020-11-01

Kolestazın nadir bir nedeni: Konjenital sağ diafragma hernisi
A rare cause of cholestasis: Congenital right diaphragmatic hernia

Didem GÜLCÜ TAŞKIN [1] , Şenol EMRE [2] , Evrim ÖZMEN [3] , Nuray KEPİL [4] , İbrahim ADALETLİ [5] , Tufan KUTLU [6] , Fugen CULLU [7] , Tulay ERKAN [8] , Osman SENYUZ [9]


82 günlük kız hasta ani gelişen sarılık, akolik dışkılama olması nedeniyle yapılan Abdominal Ultrasonografisinde safra kesesinin görülmemesi üzerine kliniğimize yönlendirildi. Akciğer grafisinde sağ diyafram elevasyonu mevcut idi. Hastanın muayenesinde aynı tarafta solunum sesleri azalmış olarak alınıyor idi. Çekilen Tomografisinde sağ diyafragmatik herni mevcut ve karaciğer ile safra kesesi toraks boşluğuna herniye idi. Olgumuzda sağ Bochdalek hernisi mevcut idi ve safrayollarının torasik kavitede sıkışmasına bağlı obstrüktif sarılık gelişmiş idi. Operasyon sırasında alınan karaciğer biyopsisinde fibroz bulguları oluşmaya başlamış idi. Operasyona alınan hastanın abdominal organları yerine alınarak, kolesistektomi ve hepatikojejunostomi operasyonu yapıldı. Erken tanı ve tedavi ile hastanın takibinde yapılan karaciğer biyopsisinde karaciğerde gelişen bulguların düzelmeye başladığı görüldü. Kolestaz, çok çeşitli etyolojik nedenlere bağlı olabilmekle birlikte cerrahi nedenlerin ivedilikle tanı ve tedavisinin yapılması prognoz açısıdan önem arz etmektedir. Bu olgu ile Bochdalek hernisinin çok farklı bir prezantasyon şeklini sunmak istedik. Kolestaz ile gelen akolik dışkısı mevcut olan hastaların ayırıcı tanısında diafragma hernisi de akılda tutulmalıdır.
An 82-day-old infant, investigated for sudden onset jaundice and acholic feces, was referred to our department, as no gallbladder was observed by abdominal ultrasonography. Her chest x-ray revealed an elevated right diaphragm, and the breath sounds were diminished on the right. Suspicious arteriovenous malformation in the fifth segment of the right lobe accompanied by a rotation anomaly of liver was reported. Tomography scans showed right diaphragmatic hernia where the left lobe of liver and gallbladder herniated to the thoracic space. In this case with right Bochdalek hernia, the bile ducts had kinked in the thoracic cavity, causing obstructive jaundice. If the kinking continues despite relocation of organs into the abdominal cavity, cholecystectomy-hepaticojejunostomy is an effective and reliable surgical method. Myriad pathologies may cause cholestasis, and surgical reasons should be investigated and diagnosed without delay to improve prognosis. For closure of the diaphragmatic defect, primary repair should be the preferred method. With this case, we wanted to emphasize a highly different presentation of Bochdalek hernia and remind that diaphragmatic hernia should be kept in mind in patients presenting with cholestasis and acholic stools.
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Primary Language en
Subjects Gastroenterology and Hepatology
Journal Section Case report
Authors

Orcid: 0000-0002-2746-3799
Author: Didem GÜLCÜ TAŞKIN (Primary Author)
Institution: Adana City Training and Research Hospital, Adana, Turkey.
Country: Turkey


Orcid: 0000-0001-9526-7151
Author: Şenol EMRE
Institution: Pediatric Surgery, Istanbul University, Cerrahpasa Medical Faculty, İstanbul, Turkey.
Country: Turkey


Orcid: 0000-0003-3100-4197
Author: Evrim ÖZMEN
Institution: Radyology, Istanbul University, Cerrahpasa Medical Faculty, İstanbul, Turkey.
Country: Turkey


Orcid: 0000-0001-5494-6422
Author: Nuray KEPİL
Institution: Pathology, Istanbul University, Cerrahpasa Medical Faculty, İstanbul, Turkey.
Country: Turkey


Orcid: 0000-0003-4531-6466
Author: İbrahim ADALETLİ
Institution: Radyology, Istanbul University, Cerrahpasa Medical Faculty, İstanbul, Turkey.
Country: Turkey


Orcid: 0000-0001-8396-4048
Author: Tufan KUTLU
Institution: Pediatric Gastroenterology, Istanbul University, Cerrahpasa Medical Faculty, İstanbul, Turkey.
Country: Turkey


Orcid: 0000-0003-0886-1422
Author: Fugen CULLU
Institution: Pediatric Gastroenterology, Istanbul University, Cerrahpasa Medical Faculty, İstanbul, Turkey
Country: Turkey


Orcid: 0000-0002-8924-2799
Author: Tulay ERKAN
Institution: Pediatric Gastroenterology, Istanbul University, Cerrahpasa Medical Faculty, İstanbul, Turkey.
Country: Turkey


Orcid: 0000-0002-0652-5524
Author: Osman SENYUZ
Institution: Pediatric Surgery, Istanbul University, Cerrahpasa Medical Faculty, İstanbul, Turkey.
Country: Turkey


Dates

Publication Date : November 1, 2020

Bibtex @case report { josam731192, journal = {Journal of Surgery and Medicine}, issn = {}, eissn = {2602-2079}, address = {jsurgmed@gmail.com}, publisher = {Fatih BAŞAK}, year = {2020}, volume = {4}, pages = {1089 - 1091}, doi = {10.28982/josam.731192}, title = {A rare cause of cholestasis: Congenital right diaphragmatic hernia}, key = {cite}, author = {Gülcü Taşkın, Didem and Emre, Şenol and Özmen, Evrim and Kepi̇l, Nuray and Adaletli̇, İbrahim and Kutlu, Tufan and Cullu, Fugen and Erkan, Tulay and Senyuz, Osman} }
APA Gülcü Taşkın, D , Emre, Ş , Özmen, E , Kepi̇l, N , Adaletli̇, İ , Kutlu, T , Cullu, F , Erkan, T , Senyuz, O . (2020). A rare cause of cholestasis: Congenital right diaphragmatic hernia . Journal of Surgery and Medicine , 4 (11) , 1089-1091 . DOI: 10.28982/josam.731192
MLA Gülcü Taşkın, D , Emre, Ş , Özmen, E , Kepi̇l, N , Adaletli̇, İ , Kutlu, T , Cullu, F , Erkan, T , Senyuz, O . "A rare cause of cholestasis: Congenital right diaphragmatic hernia" . Journal of Surgery and Medicine 4 (2020 ): 1089-1091 <http://jsurgmed.com/en/pub/issue/57748/731192>
Chicago Gülcü Taşkın, D , Emre, Ş , Özmen, E , Kepi̇l, N , Adaletli̇, İ , Kutlu, T , Cullu, F , Erkan, T , Senyuz, O . "A rare cause of cholestasis: Congenital right diaphragmatic hernia". Journal of Surgery and Medicine 4 (2020 ): 1089-1091
RIS TY - JOUR T1 - A rare cause of cholestasis: Congenital right diaphragmatic hernia AU - Didem Gülcü Taşkın , Şenol Emre , Evrim Özmen , Nuray Kepi̇l , İbrahim Adaletli̇ , Tufan Kutlu , Fugen Cullu , Tulay Erkan , Osman Senyuz Y1 - 2020 PY - 2020 N1 - doi: 10.28982/josam.731192 DO - 10.28982/josam.731192 T2 - Journal of Surgery and Medicine JF - Journal JO - JOR SP - 1089 EP - 1091 VL - 4 IS - 11 SN - -2602-2079 M3 - doi: 10.28982/josam.731192 UR - https://doi.org/10.28982/josam.731192 Y2 - 2020 ER -
EndNote %0 Journal of Surgery and Medicine A rare cause of cholestasis: Congenital right diaphragmatic hernia %A Didem Gülcü Taşkın , Şenol Emre , Evrim Özmen , Nuray Kepi̇l , İbrahim Adaletli̇ , Tufan Kutlu , Fugen Cullu , Tulay Erkan , Osman Senyuz %T A rare cause of cholestasis: Congenital right diaphragmatic hernia %D 2020 %J Journal of Surgery and Medicine %P -2602-2079 %V 4 %N 11 %R doi: 10.28982/josam.731192 %U 10.28982/josam.731192
ISNAD Gülcü Taşkın, Didem , Emre, Şenol , Özmen, Evrim , Kepi̇l, Nuray , Adaletli̇, İbrahim , Kutlu, Tufan , Cullu, Fugen , Erkan, Tulay , Senyuz, Osman . "A rare cause of cholestasis: Congenital right diaphragmatic hernia". Journal of Surgery and Medicine 4 / 11 (November 2020): 1089-1091 . https://doi.org/10.28982/josam.731192
AMA Gülcü Taşkın D , Emre Ş , Özmen E , Kepi̇l N , Adaletli̇ İ , Kutlu T , Cullu F , Erkan T , Senyuz O . A rare cause of cholestasis: Congenital right diaphragmatic hernia. J Surg Med. 2020; 4(11): 1089-1091.
Vancouver Gülcü Taşkın D , Emre Ş , Özmen E , Kepi̇l N , Adaletli̇ İ , Kutlu T , Cullu F , Erkan T , Senyuz O . A rare cause of cholestasis: Congenital right diaphragmatic hernia. Journal of Surgery and Medicine. 2020; 4(11): 1089-1091.
IEEE D. Gülcü Taşkın , Ş. Emre , E. Özmen , N. Kepi̇l , İ. Adaletli̇ , T. Kutlu , F. Cullu , T. Erkan and O. Senyuz , "A rare cause of cholestasis: Congenital right diaphragmatic hernia", Journal of Surgery and Medicine, vol. 4, no. 11, pp. 1089-1091, Nov. 2020, doi:10.28982/josam.731192