Congenital Diaphragmatic Hernia - A Late Presentation
Anjali Bharani, Hemant Jain.
Department of Pediatrics, Mahatma Gandhi Memorial Medical College, Indore, Madhya Pradesh, India.
Abstract
Congenital diaphragmatic hernia (CDH) occurs due to incomplete muscularization of the diaphragm. While majority of these are diagnosed either antenatally or in the immediate new-born period in view of respiratory distress, a few may remain undiagnosed beyond neonatal period as they are asymptomatic or minimally symptomatic. We report two such cases who presented with respiratory distress and were diagnosed to have late presenting CDH. An eight-year-old male child with weight of 12 kg presented with intermittent fever and cough for one-month, abdominal distension, and occasional bilious vomiting for 15 days and respiratory distress for 2 days. Ultrasonography of the chest revealed herniation of abdominal contents in the left chest cavity and sub-acute intestinal obstruction. He underwent surgery but succumbed to his illness. A 2-year-old female child came to the emergency department with fever, cough for 20 days and respiratory distress for 4 days. X-ray chest showed left large air-fluid filled cavity in the left lung. She underwent emergency laparotomy and a defect in the left hemi-diaphragm with herniation of stomach was noted. The hernia contents were reduced, and diaphragmatic defect closed. Post operatively she recovered well and was discharged after 7 days with full recovery.

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