scholarly journals Atypical presentation of congenital diaphragmatic hernia: case report

2019 ◽  
Vol 6 (5) ◽  
pp. 2228
Author(s):  
Sunita Arora ◽  
Gurpreet Kaur
Keyword(s):  
Respiratory Distress ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Neonatal Period ◽  
Gastrointestinal Symptoms ◽  
Abdominal Distension ◽  
Female Child ◽  
Severe Respiratory Distress ◽  
Radiographic Findings ◽  
Initial Symptoms

The Congenital diaphragmatic hernia generally presents with severe respiratory distress in the neonatal period and usually occurs once in every 2,000-3500 births. Late-presenting congenital diaphragmatic hernia (CDH) has been defined as CDH diagnosed after the neonatal period due to initial symptoms after the neonatal period or asymptomatic CDH found in the course of routine X-ray examination of the chest beyond the neonatal period. When late presentations occur, patients may be asymptomatic or may be critically ill with unusual respiratory and gastrointestinal symptoms. Case characteristics: 3yrs old female child presented with history of pain abdomen, abdominal distension, vomiting, respiratory distress and fever since 5days. Chest tube was inserted in view of left sided pleural effusion. Later on, diagnosed with diaphragmatic hernia. Outcome Child was operated, and diaphragmatic repair done and was discharged successfully after 38 days. Message: Congenital diaphragmatic hernia should be considered in the differential diagnosis of any child with unusual respiratory or gastrointestinal symptoms and abnormal chest radiographic findings.

scholarly journals Congenital diaphragmatic hernia; masquarding as hydropneumothorax

2014 ◽  
Vol 9 (3) ◽  
pp. 54-56
Author(s):  
RP Yadav ◽  
CS Agrawal ◽  
OP Pathania ◽  
P Shrestha ◽  
S Sharmal ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Neonatal Period ◽  
Chest Drain ◽  
Medical Sciences ◽  
Diaphragmatic Hernias

Congenital diaphragmatic hernia occurs in about 1 in 3000 births among which over 90% of the patients will be diagnosed either antenatally or will present with respiratory distress in the first few hours of life and about 5% to 30% of diaphragmatic hernias present beyond the neonatal period. The extent of herniation of abdominal viscera into the thorax may vary, leading to acute or intermittent symptoms. The inappropriate insertion of a chest drain, although relieving the symptoms temporarily, may result in serious consequences by damaging intrathoracic abdominal viscera. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-3, 54-56 DOI: http://dx.doi.org/10.3126/jcmsn.v9i3.10223   

scholarly journals CONGENITAL DIAPHRAGMATIC HERNIA

2010 ◽  
Vol 17 (03) ◽  
pp. 516-519
Author(s):  
MEHRSIMA ABDOLLAHZADEH ◽  
FARNOUSH FARZI ◽  
MOHAMMAD HOSSEIN GHORBANI ◽  
Sasan Bozorgi Far
Keyword(s):  
Case Report ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Neonatal Period ◽  
Late Onset ◽  
Case Reports ◽  
Anesthetic Management ◽  
Gastrointestinal Symptoms ◽  
Male Infant ◽  
Pediatric Hospital

We report a case of late-presenting congenital diaphragmatic hernia (CDH) in a three-month-old male infant presenting to the pediatric hospital with attacks of cough and cyanosis .Although CDH is usually manifested on the first day of life, there are a number of case reports of late-presenting CDH usually presenting with respiratory or gastrointestinal symptoms. In this case report, we have focused on the anesthetic management of late-presenting CDH. Text: Congenital diaphragmatic hernia is usually manifested on the first days of life as respiratory distress and a scaphoid abdomen. The abnormality is herniation of the abdominal viscera through a defect in the diaphragm, most commonly the foramen of Bochdalek on the left side1. These infants often have a dramatic presentation3, in contrast, late onset or late- presenting CDHs present outside the neonatal period with variable signs and symptoms4. We describe a case of late-presenting CDH that referred to the pediatric hospital with attacks of cough and cyanosis.

scholarly journals Late presentation of congenital diaphragmatic hernia: Case report

2015 ◽  
Vol 143 (9-10) ◽  
pp. 604-608 ◽  
Author(s):  
Sasa Radovic
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Clinical Manifestation ◽  
Diaphragmatic Hernia ◽  
Neonatal Period ◽  
Abdominal Cavity ◽  
Gastrointestinal Symptoms ◽  
Inadequate Response ◽  
Hernia Sac ◽  
Right Lobe ◽  
The Right

Introduction. Congenital diaphragmatic hernia (CDH) is a defect of the diaphragm with the penetration of organs of the abdominal cavity into thorax. Localization and size of the defect of the diaphragm condition the time and range of clinical manifestation. The most common is unilateral, without hernia sac, located on the left side, through posterolateral opening of the diaphragm and with clinical manifestation during the neonatal period. Smaller subgroup consists of patients with presentation outside the neonatal period with anatomic defect on the right side as is the case with our patient. Case Outline. Female infant aged seven months was hospitalized because of repeated episodes of shortness of breath and cough, with lack of progress in body weight. The discomforts had been present for the previous two months with an inadequate response to bronchodilator and antibiotic therapy used. After clinical, radiographic, ultrasound and computed tomography treatment, the right-sided diaphragmatic hernia was diagnosed, so surgical treatment followed. The defect of the diaphragm with hernia sac, through which the right lobe of the liver with visible line of entrapment, in the form of ?hourglass?, is pushed into thoracic cavity, was intraoperatively identified. The reposition of the right lobe of the liver in the abdominal cavity along with reconstruction of the diaphragm using interrupted mattress sutures was performed. Conclusion. The late manifestation of CDH should be suspected in cases of inexplicable acute or chronic respiratory or gastrointestinal symptoms with pathological radiography of the thorax. Accurate diagnosis and timely minimally invasive surgical intervention ensure an excellent prognosis.

Hérnia Diafragmática Congênita: Relato de Caso/ Congenital Diaphragmatic Hernia: Case Report

1970 ◽  
Vol 3 (1) ◽  
pp. 27-34
Author(s):  
Lucas Tavares Dos Santos ◽  
Tânia Massini Evangelista
Keyword(s):  
Case Report ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Neonatal Intensive Care ◽  
Esophageal Hiatus ◽  
Bochdalek Hernia ◽  
Severe Respiratory Distress ◽  
X Ray ◽  
Venous Catheterization ◽  
Terapia Intensiva

Introdução: A hérnia diafragmática congênita é a falha do fechamento embrionário do músculo diafragmático, resultando em um defeito de continuidade. Esta patologia pode ocorrer pela passagem de estruturas do abdome através de um defeito no diafragma, ou haver herniação parcial do estômago através do hiato esofágico, paralisia frênica com deslocamento do conteúdo abdominal para cima, mas sem herniação, e, eventração do diafragma. Casuística: Foi relatado um caso de hérnia diafragmática congênita, hérnia de Bochdalek, em um recém – nascido do sexo feminino, que nos ultra-sonografias da gestante apresentavam sem alterações. O diagnóstico da patologia foi feito apenas após a realização de raios-X de tórax e abdome para confirmar a posição do cateterismo umbilical venoso. Discussão/Conclusão: A apresentação clínica da hérnia de diafragmática congênita inclui desconforto respiratório moderado a grave com repercussão sistêmica. O diagnóstico, em cerca de 80% dos casos, é feito por ultrassom pré-natal. O tratamento proposto foi intubação endotraqueal com ventilação mecânica e programação para correção cirúrgica da hérnia. Após correção cirúrgica da patologia, a paciente permaneceu na unidade de terapia intensiva neonatal por 21 dias para acompanhamento de pós – operatório e intercorrências na evolução. Palavras-chave: hérnia diafragmática congênita, recém-nascido, hérnia de BochdalekABSTRACTIntroduction: Congenital diaphragmatic hernia is the failure of embryonic closure of the diaphragm, resulting in a lack of continuity. This condition can occur by passing structures of the abdomen through a defect in the diaphragm, or be part herniation of the stomach through the esophageal hiatus, phrenic paralysis with displacement of abdominal contents up but no herniation, and eventration of the diaphragm. Case Report: We report a case congenital diaphragmatic hernia, such as Bochdalek hernia, in a new - born female that in ultrasounds of pregnant women showed without change. The diagnosis of the disease was made only after conducting X-ray of the chest and abdomen to confirm the position of umbilical venous catheterization. Discussion/Conclusion: Clinical presentation of congenital diaphragmatic hernia includes moderate to severe respiratory distress with systemic repercussions. The diagnosis in about 80% of the cases is done by ultrasound prenatally. The proposed treatment was endotracheal intubation with mechanical ventilation and programming for surgical correction of the hernia. After surgical pathology, the patient remained in neonatal intensive care unit for 21 days to monitor post - operative complications and evolution.  Keywords: congenital diaphragmatic hernia, newborn, Bochdalek hernia 

scholarly journals Late-Presenting Left-Sided Morgagni Congenital Diaphragmatic Hernia in a 9-Year-Old Male

2011 ◽  
Vol 2011 ◽  
pp. 1-4
Author(s):  
Jennifer M. Kim ◽  
Marisa Couluris ◽  
Bruce M. Schnapf
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Gastrointestinal Symptoms ◽  
Lower Lobe ◽  
Abdominal Radiograph ◽  
Rare Occurrence ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
Diaphragmatic Hernias ◽  
Vague Abdominal Pain

Congenital diaphragmatic hernias are common, primarily occurring through the foramen of Bochdalek. However, in contrast, defects through the foramen of Morgagni are much more rare. When late presentations occur, patients may be asymptomatic or may be critically ill with respiratory and gastrointestinal symptoms. In this paper, we present a 9-year-old male who presented with recurrent, vague abdominal pain, and a previously normal abdominal CT scan. Initial investigation via an abdominal radiograph demonstrated an unexpected left lower lobe abnormality. Further evaluation and management revealed this abnormality to be an unusual left-sided congenital diaphragmatic hernia that appeared through the retrosternal foramen of Morgagni, a rare occurrence.

scholarly journals Right Congenital Diaphragmatic Hernia Associated With Hepatic Pulmonary Fusion: A Case Report

2016 ◽  
Vol 5 (3) ◽  
pp. 35 ◽  
Author(s):  
Rachida Laamiri ◽  
Samia Belhassen ◽  
Amine Ksia ◽  
Amina Ben Salem ◽  
Nahla Kechiche ◽  
...  
Keyword(s):  
Case Report ◽  
Respiratory Distress ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia

We present a case of male newborn presented with respiratory distress at 21 hours of life. The patient was operated for right congenital diaphragmatic hernia (CDH). Hepatic pulmonary fusion (HPF) was found at surgery.

scholarly journals Severe colon ischemia in patients with severe COVID-2019 infection: a report of three cases

2020 ◽  
Author(s):  
Ana Almeida ◽  
Víctor Valentí Azcárate ◽  
Carlos Sánchez Justicia ◽  
Fernando Martínez Regueira ◽  
Pablo Martí-Cruchaga ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Respiratory Distress ◽  
Severe Disease ◽  
Gastrointestinal Symptoms ◽  
Abdominal Distension ◽  
Systemic Inflammatory Response ◽  
Cytokine Storm ◽  
Colonic Ischemia ◽  
Patient Case ◽  
D Dimer

Abstract Severe disease caused by the SARS-CoV coronavirus is characterized by patients presenting with respiratory distress associated with a systemic inflammatory response syndrome (cytokine storm). Sixteen to thirty percent of COVID-19 patients also have gastrointestinal symptoms. Here we present three cases of COVID-19 who developed colonic ischemia. Three males aged 76, 68 and 56 with respiratory distress and receiving mechanical ventilation presented episodes of rectal bleeding, abdominal distension and signs of peritoneal irritation. Endoscopy (case 1) and computed tomography angiography revealed colonic ischemia and pneumoperitoneum.One patient (case 2) underwent surgery in which perforation of the gangrenous cecum and colonic ischemia was confirmed.In all three patients D-dimer levels were markedly increased (2170, 2100 and 7360 ng/mL). All three patients died shortly after diagnosis.In severe COVID-19 disease, the pathogenic cause has increasingly become attributed to the development of disseminated intravascular coagulation secondary to the systemic inflammatory response.

Late-Presenting Congenital Diaphragmatic Hernia: A Potentially Life Threatening Case

2009 ◽  
Vol 16 (2) ◽  
pp. 102-105 ◽  
Author(s):  
HY Chan ◽  
CC Wong ◽  
F Ng
Keyword(s):  
Respiratory Distress ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Clinical Symptoms ◽  
Late Onset ◽  
Sudden Onset ◽  
Mediastinal Shift ◽  
Wide Range ◽  
Urgent Operation ◽  
Life Threatening

Congenital diaphragmatic hernia (CDH) generally presents with respiratory distress in the neonatal period. Late onset CDH is less common and is associated with a wide range of clinical symptoms. We report a case of a 4-year-old child presenting with sudden onset of dizziness, abdominal pain and vomiting after swimming. Radiological investigations showed a left CDH with mediastinal shift. She gradually developed respiratory distress after admission. Urgent operation showed that the contents of the hernia included stomach, spleen, small and large bowels. This case highlights the importance of suspicion of CDH, proper clinical examination and investigation of children with acute non-specific gastrointestinal complaints.

Congenital Diaphragmatic Hernia: Two Case Studies with Atypical Presentations

2006 ◽  
Vol 25 (4) ◽  
pp. 239-249 ◽  
Author(s):  
Barbara Puckett
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
High Frequency ◽  
Pulmonary Hypoplasia ◽  
High Frequency Ventilation ◽  
Ultrasound Screening ◽  
Severe Respiratory Distress ◽  
The Family ◽  
Frequency Ventilation ◽  
Atypical Presentations

Congenital diaphragmatic hernia (CDH) affects 1 in every 2,000 to 4,000 live births. Many infants with this condition are diagnosed antenatally through routine ultrasound screening. Nearly 90 percent present at delivery with severe respiratory distress requiring intubation. Many of these infants develop persistent pulmonary hypertension of the newborn due to hypoplasia of the affected lung. The survival of infants with CDH is limited by the degree of pulmonary hypoplasia and requires sophisticated medical technology such as high-frequency ventilation and inhaled nitric oxide. Some infants also require treatment with extracoporeal membrane oxygenation. This article gives details of two cases of CDH in which the presentation was atypical. The more subtle presentation is discussed, as well as the embryology and pathophysiology of CDH and the possibility of associated anomalies. Clinical management and impact on the family are outlined.

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