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ISSN 2007-3194 (Print)
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2016, Number 2

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Arch Inv Mat Inf 2016; 8 (2)

Congenital diaphragmatic hernia of late presentation. Frequency and experience in the possibilities of surgical medical treatment

Flores LSL, Alba PRA, Galindo RF, Reyes BME

Language: Spanish
References: 28
Page: 48-54
PDF size: 99.14 Kb.


ABSTRACT

Introduction: Congenital diaphragmatic hernia of late presentation remains a diagnostic challenge and in its surgical medical treatment due to the pathophysiological alterations that lead to its variable presentation and this to its mortality. There are multiple measures to establish a timely and adequate diagnosis to the patient and increase survival, always recording that their spectrum of presentation is so broad that requires multidisciplinary management. Objectives: To determine the frequency of late diaphragmatic hernia and surgical medical treatment performed in patients admitted to the IMIEM Children’s Hospital, from January 2009 to December 2014. Material and methods: Study retrospective, descriptive, cross-sectional, and observational study with complete files with a diagnosis of congenital diaphragmatic hernia of late presentation, gender, age of hernia, affected side, risk factors, surgical factors, postsurgical factors, mortality and immediate and late postoperative complications as well as motive exit. Results: We identified 28 patients (15 men and 13 women). The posterolateral hernia (Bochdalek) was the most frequent with 53%. 33% of patients presented malrotation and intestinal malfunction as a more frequent associated malformation, pulmonary hypoplasia in 24%. The chronic presentation was presented in 22 patients, 5 patients debuted as acute presentation. Respiratory manifestations were the most frequent and malnutrition was the most reported preoperative factor present in 25% of patients. The primary closure was performed in 100% of the patients. Sepsis and pneumothorax were developed in 23% of the patients, as an associated postsurgical complication. Postsurgical factors were associated with morbidity and mortality was prolonged ventilation in 11% and malnutrition was 28%. Only three patients died. Conclusions: Congenital diaphragmatic hernia of late presentation remains a pathology that is associated with a high morbidity and mortality due to the diversity of its manifestations. The present is a report with the experience in our hospital of handling and survival of our patients.


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