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Objective: Cryoballoon (CB) ablation is a safe alternative to radiofrequency ablation in the treatment of atrial fibrillation (AF). However, phrenic nerve damage (PND) is a bothersome complication of the procedure. In this study, we aimed to establish the incidence of PND during CB and define the characteristics of affected patients. Material & Methods: In this retrospective analysis, all patients with AF that underwent CB ablation between 2013 and 2018 were included into the study. Characteristics and outcomes of patients complicated with PND were evaluated. PNP was detected by palpation of diaphragma contractions or observation of reduced diaphragma motility by fluoroscopy during the procedure. Results: Totally 653 patients were included in the study. PND was detected in 3.5% (23/653) of the patients. Median age of the patients with PNP was 56 (25-78) years and 10 patients (43.4 %) were male. The most common ablation site related with PND was RSPV (18 patients, 78%). Transient PND was observed in 16 patients (69%) of the patients which resolved within 24 hours after the procedure. In the remaining 5 patients (21%) diaphragmatic contraction was recovered at the 6th month control visit. In 2 patients (10%), phrenic nerve paralysis was still present >1 year visit Conclusion: PND is not a rare complication of CB ablation despite all the preventive maneuvers during the procedure and technological developments. However, most of the PND recovered during the follow-up.

In this work, we studied the effect of spaceflight factors on the antioxidant defense system in the respiratory muscle of diaphragma in mice located on the space station. Changes in the activity of antioxidant enzymes and the level of hydrogen peroxide have been identified.

Ultrasound guided percutaneous thermal ablation has been well acknowledged in treating hepatic malignancy. Although thermal ablation is safe for the treatment, it may induce some lethal complications such as diaphragmatic injury, bile-stained pleural fistula, and bilious pleuritis. We presented 2 cancer patients in hepatic diaphragmatic dome showed diaphragmatic injury, bile-stained pleural fistula, and bilious pleuritis after microwave ablation (MVA). The symptoms were attenuated after chest drainage and anti-infection therapy. In the literature review, 17 articles published in the recent 10 years on diaphragmatic injury after MVA for treating hepatic cancer were available. Twenty-three cases were obtained, among which 2 showed bilious pleuritis after radiofrequency treatment. Most of the lesions were adjacent to the diaphragma. Among the articles reporting the localization of lesions, most of the cases showed lesions in S8, 2 in S7, 3 in S4, and 3 in S5, respectively. Surgical recovery was required for the patients with massive diaphragmatic injury. Only 2 cases underwent thorascopic surgery. After chest drainage and anti-infection, their symptoms were attenuated to some extent. Radiofrequency or MVA may induce pleural effusion, and special attention should be paid to the diaphragmatic injury induced by thermal ablation.

Background Extracorporeal membrane oxygenation procedure (ECMO) has been established in the therapy of respiratory insufficient infants with congenital diaphragmatic hernia. In congenital diaphragmatic hernia newborns, a delay in transfer to an ECMO centre is associated with a sharp increase in mortality. Predictive factors for ECMO support are urgently needed. We evaluated the routine parameters of the first blood withdrawal after birth in congenital diaphragmatic hernia infants, hypothesizing that early signs in bone marrow affecting haematology parameters for early regulation of potentially post birth hypoxia are predictive factors for ECMO support. Materials and methods In 44 patients born with congenital diaphragmatic hernia, differential blood cell count from the first blood withdrawal after birth was examined. Descriptive statistics included median, 95% confidence intervals, minimum and maximum differentiating ECMO/early mortality vs. no ECMO. Odds ratios with CI were calculated by binary logistic regression analysis. Best predictive markers were further checked in combination with the liver-up situation in two factorial regression models. Results In our cohort, the survival rate was 77.3% (34/44). While 18 neonates received ECMO support, 26 experienced no ECMO during hospital stay. Odds ratio calculations showed that risk for ECMO support increases with augmenting leukocytes, erythrocytes, haemoglobin, haematocrit, mean cell volume and absolute immature granulocytes. Further, the risk advanced in line with the severity of congenital diaphragmatic hernia assessed by prenatal ultrasound. Conclusions We conclude that these parameters are associated with disease severity in congenital diaphragmatic hernia newborns and may be considered potentially predictive biomarkers for the necessity of ECMO support.

Konjenital diyafragma hernisi, diyafragmada defektler sonucu gelişen kalıtsal anomalilerdir. Diyafragmadaki konjenital defektten dolayı abdominal yapılar torakal kaviteye herniyason yapar. Akciğer grafisinde bağırsak anslarının toraksta görülmesi büyük oranda tanı koydurur. Diyafragma hernileri özefageal hiatustan (hiatal), paraözefageal, retrosternal (Morgagni) veya posterolateral (Bochdalek) bölgelerden gelişebilir. Bu olgu sunumunda Down sendromlu yenidoğan bir bebeğin sağ Bochdalek hernisi tanı süreci, cerrahi işlemi ve literatür karşılaştırması anlatılmıştır., Congenital diaphragmatic hernia is hereditaryanomalies resulting from defects in the diaphragm. Abdominal structuresherniate into the thoracic cavity due to congenital defect in the diaphragm.For accurate diagnosis, the presence of bowel loops in the thorax is decisiveon the chest radiograph. Diaphragmatic hernias may develop from esophagealhiatus (hiatal), paraesophageal, retrosternal (Morgagni) or posterolateral(Bochdalek) regions. In this case report, the diagnosis and surgical procedureof a Down syndrome-newborn baby with right Bochdalek hernia was discussed bycomparison of the literature.

Karaciğerde görülen en sık benign neoplazm hemanjiyomdur. Genellikle asemptomatik olup ender olarak komplikasyon oluşturabilir. Karaciğer ve senkron organ tutulumu görülebilir. Genellikle medikal takip edilir. Semptomatik, hızlı büyüme gösterir ve tanı kesin değilse cerrahi tedavi uygulanmalıdır. Bu yazıda karaciğer ve diaframda aynı dönemde görülen senkron hemanjiyomu olan bir olgu sunulmuştur. The most common benign neoplasm seen in the liver is haemangioma. It is usually asymptomatic and rarely causes complications. Liver and synchronous organ involvement can be seen. It is usually followed by medical. If symptomatic, rapid growth and diagnosis is uncertain, surgical treatment should be performed. In this article, a case who presented with synchronous haemangima on liver and diaphragma has been reported.

Giriş ve Amaç: Erişkindeçok kesitli bilgisayarlı tomografi ile insidental olarak saptanan asemptomatik BochdalekHernilerinin sıklığını araştırmak, obezite ve diyafragma krus kalınlığı ile BHarasındaki ilişkiyi değerlendirmektir.Gereçve Yöntemler: 870 adet toraks ve abdomen çok kesitlibilgisayarlı tomografi tetkiki retrospektif olarak tarandı. Bochdalek Hernisivarlığı, prevalansı ve herni lokalizasyonu araştırıldı. Bochdalek Hernisisaptanan hastalarda aksiyal kesitlerde, defekt komşuluğundan diyafragma kruskalınlığı ve umblikus hizasında sağ paramedian alandan ciltaltı yağ dokusukalınlığı ölçüldü. Ayrıca defektin boyutu ve herni kesesinin hacmi de aynıgörüntülerde hesaplandı. Daha sonra defekt boyutları ve herni kesesinin hacmiile diyafragma krus kalınlığı ve ciltaltı yağ dokusu kalınlığı arasında ilişkiolup olmadığı araştırıldı.Bulgular:30 hastada toplam 34 adet (%3,9) Bochdalek Hernisi saptandı. Bochdalek Hernisi13 (%43.3) hastada sağda, 13 (% 43.3) hastada solda, 4 (%13.3) hastada ise bilateraldi. Herni kesesininiçeriği 32 (%94) hastada omental yağ dokusundan, 1 (%3) hastada karaciğerden, 1(%3) hastada ise kolondan oluşmaktaydı. Herniye segment hacmi kadın hastalarda 153[84-361]µl, erkek hastalarda 339[202-432,5] µl hesaplanmış olup, bu değer kadınhastalarda istatistiksel açıdan anlamlı olacak şekilde daha düşüktü (p=0.032).Diyafragma krus kalınlığı ve ciltaltı yağlı doku ile hem herniye segment hacmihem de defekt boyutu arasında anlamlı bir ilişki izlenmedi (p>0.05). Sonuç:Mevcutçalışmada çok kesitli bilgisayarlı tomografi ile saptanan, insidental BochdalekHernisi sıklığı % 3.9’dur ve herniye segment hacmi kadınlarda erkeklere oranladaha düşük bulunmuştur. Obezite diğer intraabdominal hernilerin patogenezindeönemli bir rol oynamasına rağmen, asemptomatik insidental Bochdalek Hernisi ileobezite ve diyafragma krus kalınlığı arasında anlamlı bir ilişkisaptanmamıştır., Introduction:The objective of this study was to investigate the incidence of asymptomaticBochdalek’s herniae detected incidentally with Multidetector ComputedTomography and to evaluate thecorrelation of Bochdalek herniae with obesity and the thickness of thediaphragmatic crus.Materialsand Methods: A retrospective screening of the 870multidetector computed tomography images of thorax and abdomen were performed.The prevalence and localization of Bochdalek herniae were investigated. Inpatients with Bochdalek herniae, the thickness of the diaphragmatic crus fromthe border of the defect and the thickness of the subcutaneous fat tissue inthe right paramedian area at the level of umbilicus were measured in the axialsections. In addition, the size of the defect and the hernia sac volume werecalculated in the same images. Then, the presence of a correlation betweendefect sizes and hernia sac volumes and the thickness of the diaphragmatic crusand subcutaneous fat tissue were evaluated.Results:34 BH (3.9%) were detected in 30 patients. Bochdalek herniae was on the leftside in 13 patients (43.3%), on the right side in 13 patients (43.3%) and wasbilateral in 4 patients (13.3%). The content of the hernia sac consisted ofomental fat tissue in 32 patients (94%), of liver in 1 patient (3%) and ofcolon in 1 patient (3%). The segmental volume of hernia was lower in femalepatients [153µ;84µ -361µ] thanin male patients [339µ; 202µ -432.5µ] and the difference was statistically significant(p=0.032). There was no significant correlation between the thickness of thediaphragmatic crus and the subdermal fat tissue and both segmental volume anddefect size of hernia (p>0.05).Conclusions:In the present study, the incidence of the incidental Bochdalek herniaedetected with Multidetector Computed Tomography is 3.9% and the segmentalvolume of hernia is significantly lower in females compared with males.Although obesity plays an important role in the pathogenesis of intraabdominalhernia, no significant correlation between the asymptomatic incidental Bochdalekherniae and obesity and thickness of the diaphragmatic crus was detected.

We report a case of a 64-year-old female who represented two months after pituitary surgery with the novel complication of intermittent disabling post-nasal pulsatile "clicking". Imaging and endoscopic examination showed a residual sella cleft with the tumour capsule and diaphragma cupping against the anterior sella bony defect with each pulsation, causing the clicking. The clicking resolved following second redo surgical endoscopic repair to jail a fat graft within the residual cleft with a central barricade of conchal cartilage graft and onlay standard repair.

Diaphragmatic hernias (DHs) are rare complications after pediatric liver transplantation (PLT). It is now widely accepted that DHs after liver transplantation (LT) is a pediatric related condition. PLTs (under of age 18) performed between January 2013 and June 2019 at Malatya Inonu University Institute of Liver Transplantation were retrospectively scanned. Study group consisting DHs and a control group were compared. Among 280 PLTs, 8 of them were complicated with DHs (%2.9). Median age of the patients with DH was 3.0 (0.8-9.5) years. Median graft recipient weight ratio was 2.5 (0.9-4.4). Five patients were below 5th percentiles in terms of pediatric weight growth chart at the time of LT. Also, 6 patients were below 5th percentiles in terms of pediatric height growth chart. There was no statistical difference between study and control groups. There are many risk factors mentioned in literature that may be primarily responsible for DHs after PLT. These factors are left lobe and large-for-size grafts, malnutrition, trauma or diathermy of diaphragmatic nerve and vessels and immunosuppressants. In our study, we could not specify any reason that differs in DHs. In our aspect, narrow diaphragma and thorax are exposed to high intra-abdominal pressure from abdomen. Large-for-size grafts, which are specific to children, also may contribute to this affect. Excessive diathermy and trauma to diaphragmatic collaterals may aggravate the risk of DH. More patients are needed to make an exact conclusion, in order to evaluate with comparable study on this aspect.

Introduction/Background Optimal and maximal debulking surgery is the gold standard treatment for advanced stage (Stage II and III) epithelial ovarian cancer patients (AOC). In patients with disease confined to pelvis, Hudson hsyterectomy with retroperitoneal retrograde approach is a way to completely excise tumor confined to lower abdominal region. Moreover extensive upper abdominal surgical procedures are obligatory in order to achieve R0 tumor status. Methodology Between February 2017 -march 2019, 25 AOC patients operated in Akdeniz University, Department of Gynecology were retrospectively evaluated. All the patients underwent diagnostic laparoscopy and were evaluated for resectability (modified Fagotti score). When resectable, a wide midline incision was carried out. Then the liver was mobilized and upper abdominal procedures was performed. Then for pelvic disease, all retroperitoneal spaced was created, ureters were mobilised and the pelvic tumor was excised en bloc along with total pelvic pertioneum. When required rectosigmoid excision was perfromed. Intraoperative and postoperative parameters and short-term follow-up of 25 advanced stage ovarian cancer patients were analyzed. Results Seven patients were subjected to neo-adjuvant chemo. Optimal debulking was achieved in 16 patients out of 18 primary debulked patients. In five patients rectosigmoid excision, in seven 7 diaphragma stripping, in two patients celiac truncus lymphadenectomy were performed. Mean operation time was 390 min (300–460 min). Median blood loss was 400 cc (200–800 cc). Postoperatively 2 patient experienced eviceration and were re-operated. Three patients had wound breakdown. One patient had pulmonary embolus. In four patients post-operative ileus was observed which was handled conservativelyMedian follow-up time was 16 months (3–23 months). Two patients experienced recurrences both of which were treated with second-line chemo. Conclusion In patients with AOC extensive upper abdominal surgery and retrograde Hudson hsyterectomy are all feasible surgical options in order to eradicate peritoneal tumor with acceptable morbidty rates. Disclosure Nothing to disclose.

Diaphragma juglandis fructus is the dry wooden diaphragm inside walnuts and a byproduct in food processing of walnut kernels. The purpose of our research is to enrich the information on compounds in Diaphragma juglandis fructus to further discover and exploit its potential nutritional value. In this study, new quali-quantitative analytical approaches were developed to identify and determine bioactive compounds in Diaphragma juglandis fructus. Two-hundred compounds, including hydrolyzable tannins, flavonoids, phenolic acids, and quinones, were identified by UHPLC-Q-Orbitrap HRMS, more than 150 of which were first discovered in Diaphragma juglandis fructus. Among them, 21 major dietary polyphenols with health-promoting effects were successfully quantified using UHPLC-MS/MS, with total contents of 2.88-6.18 mg/g. This successful characterization and quantification of bioactive compounds in Diaphragma juglandis fructus gives a better understanding of its potential nutritional value and supports efficiently developing and reusing it instead of discarding it as agrofood waste.

The diploma thesis aims to describe the functional disorders of the upper gastrointestinal tract with an emphasis on gastroesophageal reflux disease. The theoretical part describes the anatomy, pathophysiology, etiology of GERD and treatment options. In the practical part is measured postural reactivity of the diaphragm in the selected 15 probands with GERD. We measured the postural reactivity of the diaphragm using high resolution manometry in various postural situations: lying on the back with flexion of lower limbs above the surface, standing and standing on the AIREX mat, for standing patients, we used weights of 3,6 and 9 kilos inside and outside the center of gravity. Patients also completed the GERD Health-Related Quality of Life questionnaire. The measurements confirmed an increase in resting pressure in all positions except standing, which correlated with the highest occurrence of reflux episodes in standing. The results were compared with a healthy control group. The activation of the crural part of the diaphragm was the same in both groups. We found in patients with GERD decreased coordination, delayed and influent activation of the crural diaphragm. The most significant increase in pressure in GERD patients occurred in the postural position of the flexed lower limbs and in standing...

This study is aimed to classify degrees of diaphragma sellae (DS) descent into sella turcica according to the surgical field block caused by the descent and to construct predictive imaging criteria for the degree of descent, and in addition, to determine whether there is any correlation between the degree of DS descent and the operative outcome (in the form of cerebrospinal fluid leak and/or presence of residual tumor). Totally, 72 patients were enrolled in our study. Their clinical and radiological data as well as the high definition videos of operations were retrospectively reviewed. The degree of DS descent during the operation was classified into five degrees according to surgical field block caused by the descent. We investigated the correlation between these five degrees and the clinical findings, radiological findings as well as the surgical outcomes. We found that the most important determining factors of DS descent degree were the volume and the height of the tumor portion above diaphragma opening. On the other hand, the total tumor volume, the maximum tumor height and the morphological pattern according to Wilson's system (modified from Hardy) had no statistically significant correlation with DS degree of descent. Presence of residual tumor on postoperative magnetic resonance images was significantly correlated with Wilson's classification and with supradiaphragmatic tumor height. On the other hand, cerebrospinal fluid leak showed no statistically significant difference between variable degrees of DS descent. Volumetric data of the tumor portion above the diaphragma opening are more important than morphological data for prediction of surgical field block caused by descended DS. While DS prolapse significantly increases the difficulty of the operative procedure, residual tumor presence is mainly dependent on morphological classification, especially cavernous sinus invasion.

(The objective of this study was to describe the clinical, ultrasonographical, and pathological findings of traumatic reticuloperitonitis (TRP) with its complications in a flock of sheep. Thirteen sheep in a flock died within one month's duration before two sheep were admitted to the Firat University Veterinary Medical Teaching Hospital. Three additional dead sheep were submitted for necropsy. A tentative diagnosis of TRP on two of the sheep was made based on clinical and ultrasonographic findings. A needle perforating the reticulum was removed from each sheep by surgery. The two sheep improved after the surgery. The necropsy revealed fibrous adhesions and a fistular connection between the dorso-ventral face of the reticulum to diaphragma and pericardium with 3 cm syringe needles in the other three sheep. There were congophylic amyloid deposits in the glomerular tufts, Bowman capsule and vascular walls of the liver, kidneys and spleen. Additionally, there was centrilobular necrosis indicating heart failure.Taken together; TRP is rarely seen in sheep; however, TRP and its complications may cause economic losses in sheep flocks. Ultrasonographic examination of the reticular area in sheep may be used as an ancillary diagnostic technique.

Address for Correspondence: Dr. Ashraf M. E.A. Sakran, Department of Human Anatomy, Faculty of Medicine, Umm al Qura University, P.O. Box: 7607, Makkah, Saudi Arabia. Phone: 00966568841873 or 00249912254379 E-Mail: ashrafsakran@hotmail.com 1,2,3,5,6 Department of Human Anatomy, Faculty of Medicine, Umm al Qura University, Makkah, Saudi Arabia. 4 Department of Public Health, Health Sciences College at Al.leith, Umm al Qura University, Saudi Arabia. 7,8,9,10 Medical students, Faculty of Medicine, Umm al Qura University, Makkah, Saudi Arabia. Background and objective: Precise anatomical knowledge of the sella turcica is important for neurologists and surgeons operating in the region of cavernous sinus or the surrounding structures. The current study was undertaken to record normal morphometric parameters for future reference and to determine if there is any significance difference in the sella turcica morphometry regarding the gender. Methodology: A Morphometric analysis of the Sella Turcica and structures in vicinity were done in thirty six adults’ formalin fixed cadaver’s skulls (22 male and 14 female). Results: The pituitary stalk positions were middle in majority of male cases (72.7%), the remaining 27.3% were posterior. Among female; 57.1% were middle and the remaining 42.9% were posterior, no anterior position was detected among both genders with no different between male and female (p = 0.494) Normal Optic chiasma position was detected in all female cases and in 63.6% of male cases with no significant differences regarding gender (p= 0.070). No significant different in diaphragma sella shape and opening regarding gender (p.value = 0.170 and 0.914 respectively) No significant difference between males and females concerning linear dimensions of sella turcica (length, depth and Anteroposterior diameters). Concerning diaphragma sella opening; no significant different regarding gender in transverse diameter (p.value= 0.316) while significant different was detected in anteroposterior diameter (p.value= 0.046) For interclinoid (anterior, posterior) diameters, which represented statistically significant different regarding gender in both right and left sides (p.value = 0.004 and 0.001 respectively). Conclusion: Present study will providing the normal morphometric data for future reference and further studies.

Ein abgeschwachtes Atemgerausch beim nicht intubierten, schwerverletzten Traumapatienten ist in der Regel Ausdruck eines Hamato-/Pneumothorax, insbesondere bei klinischem Anhalt fur gleichseitige Rippenfrakturen. Die vorliegende Kasuistik berichtet von einem Schwerverletzten mit einseitiger Minderbeluftung der Lunge, der trotz regelrechter Entlastungspunktion und Anlage einer Throaxdrainage eine persistierende Minderbeluftung der entsprechenden Lungenhalfte aufwies. Erst innerklinisch konnte in der radiologischen Diagnostik ein Enterothorax diagnostiziert werden. Durch das Dezellerationstrauma war es zu einer massiven intraabdominellen Druckerhohung mit anschliesender Ruptur des Zwerchfells gekommen. Mit einer Inzidenz von 0,8 – 1,6 % bei stumpfen Thoraxtraumen handelt es sich bei der traumatischen Zwerchfellruptur um eine Raritat, die bei Verlagerungen von intraabdominellen Organen in den Thorax operativ versorgt werden muss. Kleine Zwerchfellverletzungen werden initial haufig ubersehen und erst im Verlauf, falls Komplikationen z. B. im Sinne der Obstruktion (Ileus) auftreten, festgestellt.

Diaphragma juglandis fructus contains various bioactive constituents. Fourteen compounds were isolated from Diaphragma juglandis fructus by preparative high performance liquid chromatography (pre-HPLC) and high-speed counter-current chromatography (HSCCC). Their structures were identified by nuclear magnetic resonance (NMR) and electrospray ionization mass spectrometry (ESI-MS). Compounds (+)-dehydrovomifoliol (12), (6R,9R)-9-hydroxymegastigman-4-en-3-one (13) and (6R,9S)-9-hydroxymegastigman-4-en-3-one (14) are found from Juglans regia L. for the first time. Compounds dihydrophaseic acid (2), blumenol B (3) and (4S)-4-hydroxy-1-tetralone (11) are isolated from Diaphragma juglandis fructus for the first time. The anti-inflammatory effects of isolated compounds were evaluated by an in vitro model of lipopolysaccharide (LPS)-stimulated RAW 264.7 macrophages. Compounds gallic acid (1), ethyl gallate (9) and (+)-dehydrovomifoliol (12) exhibited inhibitory activity on the nitric oxide production of RAW 264.7 at a concentration of 25 μM. The result indicated that the combination HSCCC with pre-HPLC is an effective way for compound separation and purification. And Diaphragma juglandis fructus constituents have the potential for the treatment of inflammatory-related diseases.

Giris ve Amac: Eriskinde cok kesitli bilgisayarli tomografi ile insidental olarak saptanan asemptomatik Bochdalek Hernilerinin sikligini arastirmak, obezite ve diyafragma krus kalinligi ile BH arasindaki iliskiyi degerlendirmektir. Gerec ve Yontemler: 870 adet toraks ve abdomen cok kesitli bilgisayarli tomografi tetkiki retrospektif olarak tarandi. Bochdalek Hernisi varligi, prevalansi ve herni lokalizasyonu arastirildi. Bochdalek Hernisi saptanan hastalarda aksiyal kesitlerde, defekt komsulugundan diyafragma krus kalinligi ve umblikus hizasinda sag paramedian alandan ciltalti yag dokusu kalinligi olculdu. Ayrica defektin boyutu ve herni kesesinin hacmi de ayni goruntulerde hesaplandi. Daha sonra defekt boyutlari ve herni kesesinin hacmi ile diyafragma krus kalinligi ve ciltalti yag dokusu kalinligi arasinda iliski olup olmadigi arastirildi. Bulgular: 30 hastada toplam 34 adet (%3,9) Bochdalek Hernisi saptandi. Bochdalek Hernisi 13 (%43.3) hastada sagda, 13 (% 43.3) hastada solda, 4 (%13.3) hastada ise bilateraldi. Herni kesesinin icerigi 32 (%94) hastada omental yag dokusundan, 1 (%3) hastada karacigerden, 1 (%3) hastada ise kolondan olusmaktaydi. Herniye segment hacmi kadin hastalarda 153[84-361] µl, erkek hastalarda 339[202-432,5] µl hesaplanmis olup, bu deger kadin hastalarda istatistiksel acidan anlamli olacak sekilde daha dusuktu (p=0.032). Diyafragma krus kalinligi ve ciltalti yagli doku ile hem herniye segment hacmi hem de defekt boyutu arasinda anlamli bir iliski izlenmedi (p>0.05). Sonuc: Mevcut calismada cok kesitli bilgisayarli tomografi ile saptanan, insidental Bochdalek Hernisi sikligi % 3.9’dur ve herniye segment hacmi kadinlarda erkeklere oranla daha dusuk bulunmustur. Obezite diger intraabdominal hernilerin patogenezinde onemli bir rol oynamasina ragmen, asemptomatik insidental Bochdalek Hernisi ile obezite ve diyafragma krus kalinligi arasinda anlamli bir iliski saptanmamistir.

The most common benign neoplasm seen in the liver is haemangioma. It is usually asymptomatic and rarely causes complications. Liver and synchronous organ involvement can be seen. It is usually followed by medical. If symptomatic, rapid growth and diagnosis is uncertain, surgical treatment should be performed. In this article, a case who presented with synchronous haemangima on liver and diaphragma has been reported., Karaciğerde görülen en sık benign neoplazm hemanjiyomdur. Genellikle asemptomatik olup ender olarak komplikasyon oluşturabilir. Karaciğer ve senkron organ tutulumu görülebilir. Genellikle medikal takip edilir. Semptomatik, hızlı büyüme gösterir ve tanı kesin değilse cerrahi tedavi uygulanmalıdır. Bu yazıda karaciğer ve diaframda aynı dönemde görülen senkron hemanjiyomu olan bir olgu sunulmuştur.