Beyond the neonatal period: unmasking late presenting congenital diaphragmatic hernia: a case report
DOI:
https://doi.org/10.18203/2349-2902.isj20254346Keywords:
Neonate, Congenital diaphragmatic hernia, Large defect, Toldt’s fasciaAbstract
Congenital diaphragmatic hernia (CDH) is a common neonatal emergency characterized by a defect in the diaphragm causing abdominal organs to herniate into the thoracic cavity. Most cases of CDH present in the neonatal period with severe respiratory distress; however, a proportion of CDH cases present beyond the neonatal period, termed as late-presenting CDH. Being relatively uncommon compared to neonatal CDH, late-presenting cases pose unique diagnostic and therapeutic challenges. In this case report we present an uncommon case of late presenting CDH where posterior lip of diaphragm was completely absent with underdeveloped anterior lip, managed successfully using local tissues and intricate surgical manoeuvres lead to favourable outcome.
References
Elhalaby EA, Abo Sikeena MH. Delayed presentation of congenital diaphragmatic hernia. Pediatr Surg Int. 2002;18:480-5.
Baglaj M. Late presenting congenital diaphragmatic hernia in children. A clinical spectrum. Pediatr Surg Int. 2004;20:658-69.
Kim DJ, Chung JH. Late-presenting congenital diaphragmatic hernia in children: the experience of single institution in Korea. Yonsei Med J. 2013;54(5):1143-8.
Bharani A, Jain H. Congenital Diaphragmatic Hernia - A Late Presentation. Pediatr Oncall J. 2021;18(1):17-9.
Mei-Zahav M, Solomon M, Trachsel D, Langer JC. Bochdalek diaphragmatic hernia: not only a neonatal disease. Arch Dis Child. 2003;88(6):532-5.
Chan H, Wong C, Ng F. Late-Presenting Congenital Diaphragmatic Hernia: A Potentially Life Threatening Case. Hong Kong J Emer Med. 2009;16(2):102-5.
Wiseman NE, MacPherson RI. “Acquired” congenital diaphragmatic hernia. J Pediatr Surg. 1977;12:657-65.
Ghabisha S, Ahmed F, Al-Wageeh S, Al-Shami E, Al-Hajri A, Aljbri W, Mohammed F. Delayed presentation of congenital diaphragmatic hernia: a case report. Pan Afr Med J. 2021;40:242.
Shin HB, Jeong YJ. Diagnostic Considerations of Late Presenting Congenital Diaphragmatic Hernia in Children: Single Center Experience. Adv Pediatr Surg. 2020;26(1):11-4.
Baerg J, Kanthimathinathan V, Gollin G. Late-presenting congenital diaphragmatic hernia: diagnostic pitfalls and outcome. Hernia. 2012;16:461-6.
Stolar CH, Dillon PW. Congenital diaphragmatic hernia and eventration. In: O’Neill JA, Rowe MI, Grosfeld JL, Fonkalsrud EW, Coran AG, editors. Pediatric Surgery. 5th edition. St. Louis: Mosby Year Book. 1988:819-37.
Clark RH, Hardin WD, Hirschl RB, Jaksic T, Lally KP, Langham MR, et al. Current surgical management of congenital diaphragmatic hernia: a report from the congenital diaphragmatic hernia study group. J Pediatr Surg. 1998;33:1004-9.
Lee SL, Poulos ND, Greenholz SK. Staged reconstruction of large congenital diaphragmatic defects with synthetic patch followed by reverse latissimus dorsi muscle. J Pediatr Surg. 2002;37:367-70.
Scaife ER, Johnson DG, Meyers RL, Johnson SM, Matlak ME. The split abdominal wall muscle flap—a simple, meshfree approach to repair large diaphragmatic hernia. J Pediatr Surg. 2003,38:174-51.
Moss L, Chen CM, Harrison MR. Prosthetic patch durability in congenital diaphragmatic hernia: a long-term follow-up study. J Pediatr Surg. 2001;36:152-4.
Okazaki T, Hasegawa S, Urushihara N, Fukumoto K, Ogura K, Minato S, et al. Toldt's fascia flap: a new technique for repairing large diaphragmatic hernias. Pediatr Surg Int. 2005;21(1):64-7.
Fukuzawa H, Tamaki A, Takemoto J, Morita K, Endo K, Iwade T, et al. Thoracoscopic repair of a large neonatal congenital diaphragmatic hernia using Gerota's fascia. Asian J Endosc Surg. 2015;8(2):219-22.