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Case Series
When the scope would not pass: Diaphragmatic hernias
1 Junior Consultant, Department of Gastroenterology, Delta Medical College and Hospital, Dhaka, Bangladesh
2 Professor, Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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Nabila Tasneem Khan
Delta Medical College and Hospital, 26/2, Principal Abul Kashem Road, Mirpur 1, Dhaka 1216,
Bangladesh
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Article ID: 101369Z01NK2022
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Khan NT, Ahmed DS. When the scope would not pass: Diaphragmatic hernias. Int J Case Rep Images 2022;13(2):237–242.ABSTRACT
Introduction: A diaphragmatic hernia is a condition characterized by herniation of the abdominal content(s) via a defect in the diaphragm. It may be congenital or may be preceded by a history of trauma.
Case Series: Here we report two cases whose diaphragmatic hernias were detected on evaluation of a difficult gastroscopy. Both cases were those of young males who presented with non-specific gastrointestinal (GI) symptoms which warranted further evaluation with upper GI endoscopy and imaging. The first patient had a history of abdominal trauma during a road traffic accident. When scope negotiation proved to be difficult, they were both investigated and found to have displacement of the stomach within the mediastinum. Surgery was done followed by uneventful recovery in both patients.
Conclusion: Diaphragmatic hernias do not always present in the background of typical settings and may be asymptomatic in many cases. However when any undue resistance is faced during endoscope negotiation, a high degree of clinical suspicion should be kept for any anatomical aberration—either congenital or acquired. This may ensure early detection and prevent life-threatening acute conditions as an acute gastric volvulus.
Keywords: Anatomical aberration, Diaphragmatic hernia, Gastric volvulus
SUPPORTING INFORMATION
Author Contributions
Nabila Tasneem Khan - Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published
Dewan Saifuddin Ahmed - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Nabila Tasneem Khan et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
