Ultrasound diagnosis of congenital Morgagni hernias: Ten years of experience at two Chinese centers

BACKGROUND Morgagni hernias are rare anomalies that are easily misdiagnosed or missed.AIM To summarize the ultrasound(US)imaging characteristics of Morgagni hernias through a comparison of imaging and surgical results.METHODS The records of children with Morgagni hernias who were hospitalized at two hospitals between January 2013 and November 2023 were retrospectively re-viewed in terms of clinical findings,US features,and operative details.RESULTS Between 2013 and 2023,we observed nine(five male and four female)children with Morgagni hernias.Upper abdominal scanning revealed a widening of the prehepatic space,with an abnormal channel extending from the xiphoid process to the right or left side of the thoracic cavity.The channel had intestinal duct and intestinal gas echoes.Hernia contents were found in the transverse colon(n=6),the colon and small intestine(n=2),and the colon and stomach(n=1).Among the patients,seven had a right-sided lesion,two had a left-sided lesion,and all of them had hernial sacs.CONCLUSION US imaging can accurately determine the location,extent,and content of Morgagni hernias.For suspected Mor-gagni hernias,we recommend performing sonographic screening first.

Clinical impact of gastrointestinal endoscopy on the early detection of pharyngeal squamous cell carcinoma: A retrospective cohort study

BACKGROUND In recent years,with the growing availability of image-enhanced gastrointestinal endoscopy,gastroenterologists have contributed to the early detection of pharyngeal squamous cell carcinomas(SCC).AIM To clarify the clinical characteristics of pharyngeal SCCs detected by gastrointestinal endoscopy.METHODS This is a retrospective cohort study conducted in a single-center,a university hospital in Japan.We retrospectively assessed the clinical records of 522 consecutive patients with oropharyngeal or hypopharyngeal SCC who were examined in our hospital between 2011 and 2018.The lesions were classified into two groups:Group GE(detected by gastrointestinal endoscopy)and Group non-GE(detected by means other than gastrointestinal endoscopy).The clinical characteristics were compared between the two groups.Continuous data were compared using the Mann–Whitney U test.Pearson’sχ2 test or Fisher's exact test was used to analyze the categorical data and compare proportions.The Kaplan–Meier method was used to estimate the cumulative patient survival rates.RESULTS In our study group,the median age was 65 years and 474 patients(90.8%)were male.One hundred and ninety-six cases(37.5%)involved the oropharynx and 326 cases(62.5%)involved the hypopharynx.Three hundred and ninety-five cases(75.7%)had some symptoms at the time of diagnosis.One hundred and forty-five(27.8%)cases had concurrent ESCC or a history of ESCC.One hundred and sixtyfour(31.4%)cases were detected by gastrointestinal endoscopy and classified as Group GE.The proportions of asymptomatic cases,cTis-1 cases and cases with no lymph node metastasis were significantly higher in Group GE than Group non-GE(61.6%vs 7.3%,P<0.001,32.9%vs 12.0%,P<0.001 and 69.5%vs 19.0%,P<0.001).Endoscopic laryngo-pharyngeal surgery or endoscopic submucosal dissection were performed in only 0.6%of the lesions in Group non-GE but in 21.3%of the lesions in Group GE(P<0.001).Overall survival was significantly longer in Group GE than in Group non-GE(P=0.018).The 2-year and 4-year survival rates were 82.5%and 70.7%in Group GE,and 71.5%and 59.0%in Group non-GE,respectively.CONCLUSION Gastrointestinal endoscopy plays an important role in the early detection and improving the prognosis of pharyngeal SCCs.