Asian Cardiovasc Thorac Ann 2005;13:398
© 2005 Asia Publishing EXchange Ltd
IMAGES IN CARDIOTHORACIC MEDICINE AND SURGERY |
Radiopathology and Positive Pressure Ventilation in Diaphragmatic Hernia
Sukru Dilege, MD,
Alper Toker, MD,
Serhan Tanju, MD,
Yusuf Bayrak, MD,
Goksel Kalayci, MD
Department of Thoracic Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey
For reprint information contact: Serhan Tanju, MD Tel: 90 216 360 2301 Fax: 90 216 478 1309 Email: drstanju{at}hotmail.com, Tasmektep sok. Cinarli apt. 34/5 , Goztepe, Kadikoy, Istanbul 81060, Turkey
A 7-year-old boy, who had a car accident, had a normal chest X-ray under positive pressure ventilation (Figure 1
). A chest X-ray revealed a large diaphragmatic hernia while spontaneous breathing (Figure 2). The images were presented to stress the effect of positive pressure ventilation on radiopathology.
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Figure 1. When the patient was mechanically ventilated under positive pressure ventilation, chest X-ray was unable to demonstrate a diaphragmatic hernia.
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Figure 2. When the patient was breathing spontaneously with a T-piece attached to the intubation tube, chest X-ray revealed a large diaphragmatic hernia with a nasogastric tube inside the stomach. This radiopathology was attributed to the negative intrapleural pressure during spontaneous ventilation.
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