A new type of retropancreatic fascia hernia in the supramesocolic space preoperatively misdiagnosed as a diaphragmatic hernia: report of two cases

Abstract Background We encountered two cases of a new type of retroperitoneal hernia. We herein report the unique features of these cases. Case presentation Case 1: A Japanese girl was born at a gestational age of 37 weeks, weighing 2550 g. She underwent laparotomic left diaphragmatic hernia repair...

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Main Authors: Yoichi Nakagawa, Hiroo Uchida, Satoshi Makita, Kazuki Yokota, Akinari Hinoki, Chiyoe Shirota, Takahisa Tainaka, Wataru Sumida, Hizuru Amano, Seiya Ogata, Aitaro Takimoto, Shunya Takada, Takuya Maeda, Yousuke Gohda
Format: Article
Language:English
Published: Japan Surgical Society 2023-01-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-023-01586-y
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author Yoichi Nakagawa
Hiroo Uchida
Satoshi Makita
Kazuki Yokota
Akinari Hinoki
Chiyoe Shirota
Takahisa Tainaka
Wataru Sumida
Hizuru Amano
Seiya Ogata
Aitaro Takimoto
Shunya Takada
Takuya Maeda
Yousuke Gohda
author_facet Yoichi Nakagawa
Hiroo Uchida
Satoshi Makita
Kazuki Yokota
Akinari Hinoki
Chiyoe Shirota
Takahisa Tainaka
Wataru Sumida
Hizuru Amano
Seiya Ogata
Aitaro Takimoto
Shunya Takada
Takuya Maeda
Yousuke Gohda
author_sort Yoichi Nakagawa
collection DOAJ
description Abstract Background We encountered two cases of a new type of retroperitoneal hernia. We herein report the unique features of these cases. Case presentation Case 1: A Japanese girl was born at a gestational age of 37 weeks, weighing 2550 g. She underwent laparotomic left diaphragmatic hernia repair for a left Bochdalek hernia at the age of one day. The postoperative course was uneventful; however, chest radiography at the age of 35 days revealed bowel gas in the mediastinum, while computed tomography exhibited intestinal prolapses from the medial side of the mesh into the thoracic cavity. Reoperation was performed at the age of 77 days, showing that the defect hole was not at the diaphragm but in the absence of retropancreatic fascia, which was connected to the posterior mediastinum from the supramesocolic space. The mediastinum space was closed with a suturing spine and artificial mesh, and the defect hole in the pancreatic body was sutured. Case 2: A Japanese boy was born at a gestational age of 40 weeks, weighing 3502 g. He was diagnosed with a left diaphragmatic hernia at birth and underwent laparotomy at the age of two days. Operative findings showed no defect hole in the diaphragm, and no intestine was observed in the abdominal cavity. After close observation of the abdominal cavity, the intestine was found around the pancreatic body, and manual reduction of the intestine was performed. The defect hole existed in the absence of the retropancreatic fascia, which was connected to the extra-pleural space. The defect hole in the pancreatic body was sutured and closed with a non-absorbable thread. Conclusions We assumed that our cases were a new type of retroperitoneal hernia, which we named “retropancreatic fascia hernia”.
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spelling doaj-art-b4675fca1f684b7183f49ea39d27d8dd2025-08-20T03:58:50ZengJapan Surgical SocietySurgical Case Reports2198-77932023-01-01911610.1186/s40792-023-01586-yA new type of retropancreatic fascia hernia in the supramesocolic space preoperatively misdiagnosed as a diaphragmatic hernia: report of two casesYoichi Nakagawa0Hiroo Uchida1Satoshi Makita2Kazuki Yokota3Akinari Hinoki4Chiyoe Shirota5Takahisa Tainaka6Wataru Sumida7Hizuru Amano8Seiya Ogata9Aitaro Takimoto10Shunya Takada11Takuya Maeda12Yousuke Gohda13Department of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine and Faculty of MedicineDepartment of Rare/Intractable Cancer Analysis Research, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineAbstract Background We encountered two cases of a new type of retroperitoneal hernia. We herein report the unique features of these cases. Case presentation Case 1: A Japanese girl was born at a gestational age of 37 weeks, weighing 2550 g. She underwent laparotomic left diaphragmatic hernia repair for a left Bochdalek hernia at the age of one day. The postoperative course was uneventful; however, chest radiography at the age of 35 days revealed bowel gas in the mediastinum, while computed tomography exhibited intestinal prolapses from the medial side of the mesh into the thoracic cavity. Reoperation was performed at the age of 77 days, showing that the defect hole was not at the diaphragm but in the absence of retropancreatic fascia, which was connected to the posterior mediastinum from the supramesocolic space. The mediastinum space was closed with a suturing spine and artificial mesh, and the defect hole in the pancreatic body was sutured. Case 2: A Japanese boy was born at a gestational age of 40 weeks, weighing 3502 g. He was diagnosed with a left diaphragmatic hernia at birth and underwent laparotomy at the age of two days. Operative findings showed no defect hole in the diaphragm, and no intestine was observed in the abdominal cavity. After close observation of the abdominal cavity, the intestine was found around the pancreatic body, and manual reduction of the intestine was performed. The defect hole existed in the absence of the retropancreatic fascia, which was connected to the extra-pleural space. The defect hole in the pancreatic body was sutured and closed with a non-absorbable thread. Conclusions We assumed that our cases were a new type of retroperitoneal hernia, which we named “retropancreatic fascia hernia”.https://doi.org/10.1186/s40792-023-01586-yRetropancreatic fascia herniaRetropancreatic fasciaDiaphragmatic herniaSupramesocolic spaceRetroperitoneal hernia
spellingShingle Yoichi Nakagawa
Hiroo Uchida
Satoshi Makita
Kazuki Yokota
Akinari Hinoki
Chiyoe Shirota
Takahisa Tainaka
Wataru Sumida
Hizuru Amano
Seiya Ogata
Aitaro Takimoto
Shunya Takada
Takuya Maeda
Yousuke Gohda
A new type of retropancreatic fascia hernia in the supramesocolic space preoperatively misdiagnosed as a diaphragmatic hernia: report of two cases
Surgical Case Reports
Retropancreatic fascia hernia
Retropancreatic fascia
Diaphragmatic hernia
Supramesocolic space
Retroperitoneal hernia
title A new type of retropancreatic fascia hernia in the supramesocolic space preoperatively misdiagnosed as a diaphragmatic hernia: report of two cases
title_full A new type of retropancreatic fascia hernia in the supramesocolic space preoperatively misdiagnosed as a diaphragmatic hernia: report of two cases
title_fullStr A new type of retropancreatic fascia hernia in the supramesocolic space preoperatively misdiagnosed as a diaphragmatic hernia: report of two cases
title_full_unstemmed A new type of retropancreatic fascia hernia in the supramesocolic space preoperatively misdiagnosed as a diaphragmatic hernia: report of two cases
title_short A new type of retropancreatic fascia hernia in the supramesocolic space preoperatively misdiagnosed as a diaphragmatic hernia: report of two cases
title_sort new type of retropancreatic fascia hernia in the supramesocolic space preoperatively misdiagnosed as a diaphragmatic hernia report of two cases
topic Retropancreatic fascia hernia
Retropancreatic fascia
Diaphragmatic hernia
Supramesocolic space
Retroperitoneal hernia
url https://doi.org/10.1186/s40792-023-01586-y
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