scholarly journals Late presentation of congenital diaphragmatic hernia: Case report

2015 ◽  
Vol 143 (9-10) ◽  
pp. 604-608 ◽  
Author(s):  
Sasa Radovic

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.

2015 ◽  
Vol 17 ◽  
pp. 28-30 ◽  
Author(s):  
E.A. De Marco ◽  
L. Merli ◽  
A. Taddei ◽  
S.M. Pulitanò ◽  
C. Manzoni ◽  
...  

2021 ◽  
Author(s):  
Mingming Yu ◽  
Fang Chen ◽  
Sisi Wei ◽  
Hua Xie

Abstract BackgroundIntrathoracic kidney (ITK) associated with congenital diaphragmatic hernia (CDH) is rare congenital anomaly and usually requires surgery. The surgical methods and approaches are diverse.Case presentationWe reported a case of a 5-year-old boy who was diagnosed as right-sided ITK with CDH. Surgical treatment was performed by combined thoracoscopic and laparoscopic approach. Anatomical reposition of the right kidney and nephropexy were carried out under laparoscopy, and repair of the hernia was performed under thoracoscopy. The postoperative recovery was uneventful and long-term follow-up demonstrated normal function and development of the kidney.ConclusionCombined thoracoscopic and laparoscopic approach is minimally invasive and effective for treatment of ITK associated with CDH. It provides better visualization of the diaphragmatic foramen and the hernia sac, and can achieve anatomical reposition and fixation of the ectopic kidney.


2020 ◽  
Author(s):  
Yun-jin Wang ◽  
Liu Chen ◽  
Chao-ming Zhou ◽  
zhengmian zhang

Abstract Background:Congenital diaphragmatic hernia(CDH) is an embryonic stage in which the abdominal organs enter the thoracic cavity under the action of pressure difference between the thoracic and abdominal cavity, resulting in pulmonary hypoplasia due to the dysplasia of the diaphragm and the failure to heal the posterolateral pleura and peritoneum during the development of the diaphragm.Case presentation: A 7-month-old girl was admitted to hospital with the chief complaint of repeated vomiting for 1 day. Diagnosis was established by chest and abdominal radiographs and computerized tomography(CT). During the operation, it was found that there were many contents of intrathoracic hernia, and the hernia sac orifice was small. It was difficult to return them by thoracoscopy,then they were transferred to laparoscopic-assisted content return of diaphragmatic hernia.The patient had a good postoperative result.Conclusion: This is a very rare case of Congenital diaphragmatic hernia with small hernia sac orifice, and it emphasizes the significance of preoperative computerized tomography.


2019 ◽  
Vol 6 (5) ◽  
pp. 2228
Author(s):  
Sunita Arora ◽  
Gurpreet Kaur

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.


2010 ◽  
Vol 17 (03) ◽  
pp. 516-519
Author(s):  
MEHRSIMA ABDOLLAHZADEH ◽  
FARNOUSH FARZI ◽  
MOHAMMAD HOSSEIN GHORBANI ◽  
Sasan Bozorgi Far

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.


2011 ◽  
Vol 1 (1) ◽  
pp. 6
Author(s):  
Claire R. Jackson ◽  
Gordan A. MacKinlay ◽  
Merrill McHoney

Thoracoscopic repair of congenital diaphra­gmatic hernia (CDH) has been described by a number of authors and is increasingly widely practiced. We present a technical learning point. CDH is associated with the presence of a hernia sac in around 20% of all cases. In this case the presence of a ruptured hernia sac complicated the thoracoscopic repair of a left sided CDH, as it was initially difficult to recognise. Once the anatomy was clarified the repair was satisfactorily completed and the child made a rapid postoperative recovery. This technical note is to warn other surgeons that a tunnel like appearance of the diaphragmatic defect may in fact be due to the presence of a torn hernia sac, which requires excision before closure of the defect.


2021 ◽  
Vol 26 (4) ◽  
pp. 113-117
Author(s):  
V.O. Shaprinskyi  ◽  
O.O. Vorovskyi ◽  
O.A. Kaminskyi ◽  
Ya.M. Pashynskyi

The results of treatment of 72 patients with echinococcosis of the liver were analyzed, women – 62 (86.2%), men – 10 (13.8%). Primary echinococcosis was detected in 69 (95.8%) patients, secondary – in 3 (4.2%). Among instrumental research methods, ultrasound and computed tomography examination were of diagnostic value. Single liver cysts were found in 63 (87.5%) patients, multiple – in 9 (12.5%). Among patients with solitary cysts, the right lobe was more often affected than the left – 48 (66.7%) vs 24 (33.3%) cases. Echinococcosis of central localization was less common and was noted in 8 (11.1%) cases. Echinococcosis complications were observed in 16 (22.2%) patients. Among them, most often there were suppurations of the cyst – in 13 (18.1%); a bursting of the cyst into the free abdominal cavity – in 1 (1.4%), in the pleural cavity – 1 (1.4%), in the biliary tract – in 1 (1.4%). Partial or complete liming of the hand was observed in 12 (16.7%) patients. In 20 (27.8%) cases, the operation was performed from the upper median access, in 42 (58.3%) – from oblique hypochondria accesses by Kocher or by Fedorov. Pericystectomy was performed in 48 (66.7%) patients, in 8 (11.1%) patients underwent resections of liver segments with an echinococcal cyst, in 4 (5.6%) – cyst opening with removal of contents and treatment of its cavity. Laparoscopic echinococectomy was used in 12 (16.7%) patients. In the postoperative period complications were observed in 16 (22.2%) patients. The use of the welding electrocoagulator EK-300M "Swarmed" in the thermal rehabilitation of the walls of the residual cavity after echinococectomy allowed to reduce blood loss from 2200±210 ml to 250±50 ml. With the use of laparoscopic echinococectomy, intraoperative blood loss was reduced by 9 times (р=0.0001); duration of operation – 2 times (р<0.05), stay in hospital – 3.3 times (р=0.002). There were no fatal outcomes. Before and after operation antirelapse antiparasitic therapy with albendazole (Vormil) was performed in two cycles of 28 days, separated by a 14-day break. The dose at body weight over 60 kg was 400 mg 2 times a day, and for less than 60 kg the drug was calculated at a rate of 15 mg/kg/day. There were 2 (2.8%) cases of relapse, there was no mortality.


2016 ◽  
Vol 34 (05) ◽  
pp. 515-519 ◽  
Author(s):  
Jurica Vuković ◽  
Milivoj Novak ◽  
Toby Weingarten ◽  
Darrell Schroeder ◽  
Juraj Sprung ◽  
...  

2011 ◽  
Vol 2011 ◽  
pp. 1-4
Author(s):  
Jennifer M. Kim ◽  
Marisa Couluris ◽  
Bruce M. Schnapf

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.


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