1.4 Diaphragm - Appendix Surgery Marked PDF

Hernia Bochdalek: left posterolateral pleuroperitoneal hernia. Pushing abdominal organs into the thoracic cavity. Diaphragm Relaxation: High lying atrophic diaphragm causing phrenic nerve paralysis Accessory diaphragm: Additional like diaphragm causing partial lung compression requiring surgical re...

Hernia Bochdalek: left posterolateral pleuroperitoneal hernia. Pushing abdominal organs into the thoracic cavity. Diaphragm Relaxation: High lying atrophic diaphragm causing phrenic nerve paralysis Accessory diaphragm: Additional like diaphragm causing partial lung compression requiring surgical removal for respiratory function A. 6 - 12 hours after injury: slight inflammation, debridement, primary suture, drainage B. 12 - 24 hours after the injury: expressed inflammation, primary suture, pleural pouch, drainage C. > 24 hours from the injury: derivation, exclusion of the esophagus or esophagectomy D. The first postoperative days: gastrostomy and feeding jejunostomy Zargar classification Description Grade O Normal mucosa Grade Edema and erythema of the mucosa Grade A Hemorrhage, erosions, blisters, superficial ulcers Grade B Circumferential lesions Grade A Focal deep gray or brownish-black ulcers Grade B Extensive deep gray or brownish-black ulcers Grade Perforation Acute phase: rinsing with water, antidotes, antibiotics, corticosteroids, analgesics, intubation after the second week, dilatation in early stenoses and gastrotomies Chronic phase: dilatation and swelling Definite obstruction Operative treatment Esophagectomies and reconstructive procedures – gastric pull up, coloplasty - retrosternal and transmediastinal, palliative " By-Pass" procedure without esophagectomies, mucosal stripping, antethoracic and retrosternal