scholarly journals Thoracoscopic Patch Repair of Congenital Diaphragmatic Hernia in a Neonate using Spiral Tacks: A Case Report

2015 ◽  
Vol 4 (3) ◽  
Author(s):  
Mario A Riquelme ◽  
Carlos D Guajardo ◽  
Marco A Juarez-Parra ◽  
Rodolfo A Elizondo ◽  
Julio C Cortinas

We present a case of congenital diaphragmatic hernia that was successfully treated with spi-ral tacks using thoracoscopy. A newborn female was diagnosed with a diaphragmatic hernia at 20 weeks of gestation. The defect was surgically repaired by thoracoscopy and primary closure. On postoperative day 25, she developed respiratory distress. Chest x-ray showed a recurrence and was taken to the OR for surgical repair with spiral tacks.

1970 ◽  
Vol 3 (1) ◽  
pp. 27-34
Author(s):  
Lucas Tavares Dos Santos ◽  
Tânia Massini Evangelista

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 


2016 ◽  
Vol 5 (3) ◽  
pp. 35 ◽  
Author(s):  
Rachida Laamiri ◽  
Samia Belhassen ◽  
Amine Ksia ◽  
Amina Ben Salem ◽  
Nahla Kechiche ◽  
...  

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.


2021 ◽  
Vol 1 (2) ◽  
Author(s):  
A. Mohamed ◽  
Shankar S ◽  
Abid Qazi

Background: Anterolateral defect of diaphragm is unusual and has been reported less than 5 times in literature. Case Presentation: We are reporting a case with typical initial presentation of a congenital diaphragmatic hernia. A chest x-ray raised suspicion of a cystic lesion or diaphragmatic eventration which was excluded by chest ultrasound. At operation he was found to have a localised and large anterolateral defect with a very thick sac which was plicated to bridge the diaphragmatic defect. Conclusion: A rare variant and should be differentiated from other variants using imaging.


Author(s):  
Mohammad Momen Gharibvand

 Spontaneous pneumothorax does not occur frequently in the newborn. The prevalence of spontaneous neonatal pneumothorax is twice in male as in female neonates. It should be suspected in any neonate with respiratory distress. In this article, we present a 2.6 kg term male neonate who developed respiratory distress 14 h after birth. An urgent chest X-ray anteroposterior was ordered for evaluation. Chest X-ray revealed a left-sided pneumothorax along with mediastinal and tracheal shift to the opposite side which was suggestive of tension pneumothorax. If considerable distress persists, continuous drainage of the pneumothorax should be provided by means of an intercostal drainage and an underwater seal.


2021 ◽  
Vol 9 ◽  
Author(s):  
Aabha A. Anekar ◽  
Sumana Nanjundachar ◽  
Dhaneshgouda Desai ◽  
Jafferali Lakhani ◽  
Prakash M. Kabbur

A congenital diaphragmatic hernia (CDH) occurs when the abdominal contents protrude into the thoracic cavity through an opening in the diaphragm. The main pathology lies in the maldevelopment or defective fusion of the pleuroperitoneal membranes. Delayed diagnosis in later childhood as in the index case reported here can lead to life-threatening complications such as tension gastrothorax and gastric volvulus. Such life-threatening conditions should be managed emergently avoiding misdiagnoses and untoward harm to the patient. We report a pediatric case of an 8-year-old boy who presented with respiratory distress, chest pain, and non-bilious vomiting. He was initially diagnosed with tension pneumothorax, and the chest x-ray was interpreted as hydropneumothorax. A chest tube placement was planned but was withheld due to excessive vomiting. A nasogastric (NG) tube was placed, and a barium-filled radiograph showed an intrathoracic presence of the stomach. A diagnosis of a congenital diaphragmatic hernia with tension gastrothorax was made. The posterolateral (Bochdalek) diaphragmatic hernia was repaired successfully. This case report highlights the importance of including a late-presenting CDH in the differential diagnoses of pediatric patients who present with respiratory distress, chest pain, non-bilious vomiting, and radiological findings suggestive of tension pneumothorax.


Author(s):  
Turkay Rzayev ◽  
Efe Soydemir ◽  
Safak Gucyetmez ◽  
Gursu Kiyan ◽  
Hulya Ozdemir ◽  
...  

Background: Neonatal pneumomediastinum is seen in 2.5 per 1000 live births and mostly managed conservatively. An intervention is essential in cases with tension pneumomediastinum. Ultrasonography-guided (USG-guided) relief of pneumomediastinum has been reported in newborns. There are no reported cases of computed tomography-guided (CT-guided) drainage of pneumomediastinum in neonates. Case report: A newborn girl born at 34 week of gestation was intubated due to respiratory distress and received intratracheal surfactant treatment. Pneumomediastinum was detected at the chest X-ray on the 6th postnatal hour. On the second postnatal day, the patient's oxygen needs increased, tachypnea and subcostal retractions recurred, so it was decided to intervene. USG-guided drainage of the pneumomediastinum was attempted twice but was unsuccessful. Percutaneous drainage with CT guidance was performed successfully. Conclusion: This report aims to emphasize that CT-guided intervention of pneumomediastinum can be an effective alternative in a newborn if USG-guided intervention fails.


PEDIATRICS ◽  
1977 ◽  
Vol 60 (5) ◽  
pp. 740-742
Author(s):  
Robert J. Levy ◽  
Amnon Rosenthal ◽  
Michael D. Freed ◽  
Charles D. Smith ◽  
Angelo Eraklis ◽  
...  

Persistent elevation of pulmonary vascular resistance represents a major cause of death in infants with congenital diaphragmatic hernia.1 The present report describes an infant with diaphragmatic hernia in whom persistent pulmonary hypertension associated with severe hypoxemia was successfully treated with tolazoline hydrochloride. CASE REPORT A 3,250-g term boy was born at Boston Hospital for Women to a 31-year-old, gravida 2, para 1 woman. Pregnancy was unremarkable and labor lasted 12 hours. At delivery, Apgar scores were 5 at one minute and 7 at three minutes. There was extreme respiratory distress and hypoxemia. Intubation and a subsequent chest x-ray film led to the diagnosis of a diaphragmatic hernia.


Author(s):  
Herbert Butana ◽  
Ntawunga Laurance ◽  
Desire Rubanguka ◽  
Isaie Sibomana

Background: Diaphragmatic hernias occurring post trauma are a challenge to diagnose early especially when they follow blunt trauma. Many of those diagnosed early occur in penetrating thoraco-abdominal trauma which necessitates emergency exploration where the diagnosis is picked. Rarity of traumatic diaphragmatic hernia coupled with poor sensitivity of easily available imaging modalities makes it a big challenge to pick up this potentially fatal pathology. Case presentation: We present a rare case of tension viscerothorax in a young man who had presented to the emergency department at a provincial hospital of Rwanda three days before the second consultation where the chest x-ray was interpreted as normal and later as a pneumothorax before the diagnosis and treatment of tension viscerothorax could be made. Conclusion: Viscerothorax is an elusive diagnosis which when missed can complicate to strangulation of hernia contents or tension viscerothorax which carry a high mortality.


2016 ◽  
Vol 5 (3) ◽  
pp. 40
Author(s):  
Mario A Riquelme ◽  
Carlos D Guajardo ◽  
Marco A Juarez-Parra ◽  
Rodolfo A Elizondo ◽  
Julio C Cortinas

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