Late onset diaphragmatic hernia complicated by intestinal strangulation

Section of Neonatology, Department of Pediatrics, University of Colorado Denver School of Medicine and Children's Hospital Colorado, Aurora, Colorado 80045, USA.
Current opinion in pediatrics (Impact Factor: 2.53). 02/2012; 24(2):274-6. DOI: 10.1097/MOP.0b013e3283507909
Source: PubMed


We present a case of a 7-week-old infant who presented with nonspecific respiratory symptoms that quickly progressed to sudden cardiac arrest as a consequence of late-onset diaphragmatic hernia and intestinal strangulation. Unless discovered as an incidental finding, late-onset diaphragmatic hernia should be considered a surgical emergency.

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Available from: Paul J Rozance

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    ABSTRACT: Congenital diaphragmatic hernia (CDH) occurs when theabdominal contents protrude into the thoracic cavity throughan anatomical defect in the diaphragm. The incidence of CDHis 1 in 2500 births, with left congenital diaphragmatic hernias(LCDH) being more common than right-side hernias (85% to12%). While many cases are discovered prenatally or during theimmediate postnatal period, 5 to 25% of CDH can be latepresenting events which are detected by routine examinations,during medical check-ups, because of respiratory or gastrointestinalproblems or complications such as gastric volvulus,occlusion, perforation, peritonitis or necrosis. Trans-abdominalor trans-thoracic approach is mandatory in those cases wherecomplications have been identified. The prognosis for latepresenting patients with LCDH is usually favorable. We reportthe case of a 7-year-old girl with recent history of trauma,who was admitted to a local hospital with respiratorydistress. In our clinic, LCDH was diagnosed and closure ofthe defect was performed through an open trans-abdominalapproach with favorable outcome. Celsius.
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