|
Newly Diagnosed Diaphragmatic Hernia in a 13 Months Old
Adam Powell.
Shaw Air Force Base Pediatric Medical Director, USA.
|
|
Which type of diaphragmatic hernia does this patient have?
Morgagni hernia. Subcostosternal diaphragmatic hernias are a rare form of diaphragmatic hernia accounting for 3-5 percent of all cases. {1} Anterior defect occurs when gastrointestinal {GI} contents extend through the foramen of Morgagni, a triangular space formed when the muscle fibers of the xiphoid process and costal margin insert on the central tendon of the diaphragm. {2} This is in contrast to the more common posterolateral defects through the foramen of Bochdalek, which account for 80-90 percent of congenital diaphragmatic hernia cases. {3} The presentation differs greatly with these two hernia types. The Bochdalek hernia usually presents in the classic, acutely ill neonate requiring significant respiratory support and surgical interventions. These patients tend to have some degree of lung hypoplasia and pulmonary hypertension leading to significant morbidity and mortality, among other complications. {4} The Morgagni hernia tends to be diagnosed incidentally however presentation varies from recurrent chest infections to gastrointestinal symptoms. {5} Surgical repair is still indicated for patients with Morgagni hernias due to risk of strangulation and colonic perforation, however the timing of repair depends on the individual surgeon. {2}
Conflict of Interest: None
Funding: None
Disclosure: The opinions expressed herein are those of the author and are not necessarily representative of those of Shaw Air Force Base, the Department of Defense {DOD} or the United States Army, Navy, or Air Force. |
| |
| Compliance with ethical standards |
|
Funding: None
|
|
|
Conflict of Interest: None
|
|
- Al-Salem, AH. Congenital hernia of Morgagni in infants and children. J Pediatric Surg. 2007; 42: 1539-1543 [CrossRef] [PubMed]
- Minneci PC, Deans KJ, Kim P, Mathisen, DJ. Foramen of Morgani hernia: changes in diagnosis and treatment. Ann Thor Surg. 2004;77: 1956-1959 [CrossRef] [PubMed]
- Kim JM, Couluris M, Schnapf BM. Late-presenting Left-Sided Morgagni Congenital Diaphragmatic Hernia in a 9 Year Old Male. ISRN Pulmonology. 2011; article ID 409252.
- Peetsold MG, Heij HA, Kneepkens CM, Huisman J, Gemke RJ. The Long-Term Follow-Up of Patients with a Congenital Diaphragmatic Hernia: a Broad Spectrum of Morbidity. Pediatr Surg Int. 2009;25: 1-17 [CrossRef] [PubMed]
- Mei-Zahav M, Solomon M, Trachsel D, Langer JC. Bochdalek diaphragmatic hernia: not only a neonatal disease. Arch Dis Child. 2003; 88:532-535 [CrossRef] [PubMed] [PMC free article]
|
|
DOI: https://doi.org/10.7199/ped.oncall.2014.45 |
| |
Cite this article as:
Powell A. Newly Diagnosed Diaphragmatic Hernia in a 13 Months Old. Pediatr Oncall J. 2014;11: 94. doi: 10.7199/ped.oncall.2014.45
|