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Retrosternal hernia in a child operated for gastroschisis

Anna Porębska, Jarosław Mozgiel

CaseRepClinPractRev 2003; 4(4):299-301

ID: 449542


Background: Pathological states and surgical operations causing the pressure rise within the abdominal cavity may result in translocation of the organs from their natural position.
Case report: The article presents a case of retrosternal hernia in a female infant treated due to gastroschisis. Extruded viscera included part of stomach, small intestine, large intestine oviduct, right ovary, a small portion of liver. In the first stage of treatment a prosthetic sac was sutured
into the edges of the wall of the abdominal cavity. The sac was changed on the fourteenth day. An extension apparatus was used which gradually translocated organs into the abdominal cavity. After three weeks the opposing edges of the abdominal wall were sutured together. In the third month of life increased dyspnea was noted as well as symptoms of partial intestinal occlusion. Radiographs revealed a retrosternal hernia. An operation was performed through the old operative scar. Herniation of small intestinal loops into the chest through the parasternal fissure on both sides was noted. The hernia sac was doubly folded on both sides, and the
foramens closed by suturing the edges. Simultaneous cecostomy was performed. The child was successfully treated.
Conclusions: The presence of retrosternal hernia might have been a result of the increase in intraabdominal pressure during the gradual translocation of extruded organs into the abdominal cavity.

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