Imaging clinical case
Keywords:abdominal pain, children, congenital diaphragmatic hernia, late-presentation
Congenital diaphragmatic hernia (CDH) results from incomplete closure of the pleuroperitoneal canal during fetal development, allowing herniation of abdominal contents into the thoracic cavity. It usually presents in the neonatal period with respiratory distress, but can also manifest later in life.
The diagnosis of late-onset CDH should be kept in mind in the differential diagnosis of children with acute or recurrent nonspecific symptoms, especially respiratory or gastrointestinal symptoms or both. Clinical suspicion and plain radiography remain the key to diagnosis. Early surgical correction of the diaphragmatic defect is crucial to prevent possible passage or strangulation of abdominal viscera and severe respiratory problems.
In the present report, the authors present a typical case of late-onset CDH with acute presentation of gastrointestinal symptoms (e.g., abdominal pain and vomiting). Thoracoscopic repair was performed, with reduction of the abdominal contents (small bowel and colon) and suturing of the posterior diaphragmatic defect.
Tovar JA. Congenital diaphragmatic hernia. Orphanet J Rare Dis. 2012 Jan;7:1.
Karmazyn B, Shold AJ, Delaney LR, Brown BP, Marine MB, Jennings SG, et al. Ultrasound evaluation of right diaphragmatic eventration and hernia. Pediatr Radiol 49, 1010–1017 (2019). https://doi.org/10.1007/s00247-019-04417-1.
Badillo A, Gingalewski C. Congenital diaphragmatic hernia: treatment and outcomes. Semin Perinatol. 2014 Mar;38(2):92-6. doi: https://doi.org/10.1053/j.semperi.2013.11.005. PMID: 24580764.
Bagłaj M. Late-presenting congenital diaphragmatic hernia in children: a clinical spectrum. Pediatr Surg Int. 2004 Sep;20(9):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):1143-1148. doi: https://doi.org/10.3349/ymj.2013.54.5.1143.
Cigdem MK, Onen A, Otcu S, Okur H. Late presentation of bochdalek-type congenital diaphragmatic hernia in children: a 23-year experience at a single center. Surg Today. 2007;37(8):642–5.
Rygl M, Pycha K, Stranak Z, Melichar J, Krofta L, Tomasek L, et al. Congenital diaphragmatic hernia: onset of respiratory distress and size of the defect. Pediatr Surg Int [Internet]. 2007;23(1):27–31. Available from: https://doi.org/10.1007/s00383-006-1788-3.
How to Cite
Copyright (c) 2023 André Morais, Ana Luísa de Carvalho, Catarina Barroso, Maria João Magalhães, Vera Baptista , Liliana Abreu , Margarida Reis Morais
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright and access
This journal offers immediate free access to its content, following the principle that providing free scientific knowledge to the public provides greater global democratization of knowledge.
The works are licensed under a Creative Commons Attribution Non-commercial 4.0 International license.
Nascer e Crescer – Birth and Growth Medical Journal do not charge any submission or processing fee to the articles submitted.