A retrospective study in the detection of i̇nci̇dental diaphragmati̇c hernias in adult population with multislice computed tomography

ABSTRACT Aim The aim of this thesis is to retrospectively assess the proportion, distrubition and properties of incidentally detected diaphragmatic hernies ( Morgagni, Bochdaleck and Hiatal hernies) in multislice Computer Tomography (CT) studies of adults and compare with literature. Material and Method: We retrospectively assessed CT findings of 1000 patients (670 abdomen and 330 thorax CT) admitted to Dicle University department of radiology between february 2013 and may 2013 with various clinical diagnosis. Archive of our radilogy clinic and patient records which comprise 16 detector Toshiba Activion ve 64 detector Philips Brillance CT studies have been used. Primarily we investigate whether diaphragmatic hernia exists or not. The patients those have diaphragmatic hernia have been divided to three groups as Morgagni, Bochdaleck ve Hiatal hernia. After determine frequency we divided hernias to subgroups according to their content. Findings Of these patients, totally 211 hernias were detected in 192 patients (%19.2). Among these hernias, 51% Morgagni , 37% Hiatal , and 12% were Bochdaleck hernia. Frequency of hernias in main patient group 10.7% for Morgagni, 7.8% for Hiatal and 2.6% for Bochdalek hernia. 99% of Morgagni hernia were include just omental fatty tissue while remaining were include both fat tissue and bowel loop. 84% of Morgagni hernias were right sided, 12% left sided and remaining were bilateral. Hiatus hernia were sliding type(75% ), mixed type(17%) and paraeusophagial type(8%). 69% of Bochdalek hernias were left sided and 31% were right sided. Patients those have hernia (192 individuals) were diagnosed with single (88%), double (11%) and triple(1%) type of hernias. Patients with double type of hernia were including Morgagni and Hiatus (50%), Morgagni and Bochdalek (23%)and Bochdalek and Hiatus hernia(27%). Conclusion Increased using of thin sectional and low collimation cross sectional imaging techniques like multislice CT for thoracic and abdominal pathologies has eased incidental diagnosis of diaphragmatic hernia which raised their frequency. Diaphragmatic hernias were detected with highest ratio by using multisclice CT(% 19.2). The most common hernia type was Morgagni consequented by Hiatal and Bochdalek hernia, respectively.