2023, Number 4
<< Back Next >>
Rev Fac Med UNAM 2023; 66 (4)
Late Presentation Congenital Diaphragmatic Hernia: Case Report with Literature Review
del Real-Machain V, Bolaņos-Pano LO, Parra-Ibarraran A, Mercado-Cruz E
Language: Spanish
References: 10
Page: 26-34
PDF size: 313.41 Kb.
ABSTRACT
A congenital diaphragmatic hernia occurs when the diaphragm
has a structural defect that allows the migration
of abdominal organs into the chest cavity. It is called late
presentation when its diagnosis does after 30 days of life.
More than 60% of patients with congenital diaphragmatic
hernia are misdiagnosed. The most common misdiagnoses
are pleural effusion, pneumonia, pneumothorax, pneumatocele,
and lung abscess.
We present a case of a 3-year-old female who attended
the emergency room due to abdominal pain, nausea, vomiting,
intolerance to the oral route, and respiratory distress.
The chest X-ray showed migration of the gastric chamber
towards the thorax, displacement of the cardiac silhouette
and the mediastinal structures to the right, and the tip of the
nasogastric tube located in the left hemithorax. The doctors
concluded a late presentation diaphragmatic hernia. The
patient received surgical treatment, which was successful.
This paper highlights the importance of suspecting the
diagnosis of late-onset congenital diaphragmatic hernia
when treating pediatric patients with respiratory distress
without another apparent cause, abdominal pain, nausea,
and vomiting.
REFERENCES
Ghabisha S, Ahmed F, Al-Wageeh S, et al. Delayedpresentation of congenital diaphragmatic hernia: a casereport. Pan Afr Med J. 2021;40(242). Doi: 10.11604/pamj.2021.40.242.32113
Kardon G, Ackerman KG, McCulley DJ, et al. Congenitaldiaphragmatic hernias: from genes to mechanismsto therapies. Dis Model Mech. 2017;10(8):955-70. Doi:10.1242/dmm.028365
Muien MZA, Jeyaprahasam K, Krisnan T, et al. Rare latepresentationcongenital diaphragmatic hernia mimicking atension pneumothorax. Radiol Case Rep. 2021;16(9):2542-2545. Doi: 10.1016/j.radcr.2021.06.024
Anekar AA, Nanjundachar S, Desai D, et al. Case Report:Late-Presenting Congenital Diaphragmatic Hernia WithTension Gastrothorax. Front Pediatr. 2021;14(9):618596.Doi: 10.3389/fped.2021.618596
Al-Salem AH. Congenital hernia of Morgagni in infantsand children. J Pediatr Surg. 2007;42(9):1539-43. Doi:10.1016/j.jpedsurg.2007.04.033
Shin HB, Jeong YJ. Late presenting congenital diaphragmatichernia misdiagnosed as a pleural effusion: A casereport. Medicine (Baltimore). 2020;12;99(24):e20684.Doi: 10.1097/MD.0000000000020684
Kosiński P, Wielgoś M. Congenital diaphragmatic hernia:pathogenesis, prenatal diagnosis and management. GinekolPol. 2017;88(1):24-30. Doi: 10.5603/GP.a2017.0005
Bagłaj M, Dorobisz U. Late-presenting congenital diaphragmatichernia in children: a literature review. Pediatr Radiol.2005;35(5):478-88. Doi: 10.1007/s00247-004-1389-z.
Goudarzi H, Hemmatizadeh M, Anbara T. Surgical techniqueof congenital diaphragmatic hernia following sleevegastrectomy; a case report study. Int J Surg Case Rep.2022;99: 107671. Doi: 10.1016/j.ijscr.2022.107671
Testini M, Girardi A, Isernia RM, et al. Emergency surgerydue to diaphragmatic hernia: case series and review. World JEmerg Surg. 201718;12:23. doi: 10.1186/s13017-017-0134-5