Congenital Diaphragmatic Hernia- Rare Case at Rare Age Group with Atypical Presentation

Authors

  • Dr. Atul Kumar Khare  Senior Resident General Surgery, GMC Shahdol Shahdol, Madhya Pradesh, India
  • Dr. Ambuj Soni  Senior Resident General Surgery, GMC Shahdol Shahdol, Madhya Pradesh, India
  • Dr. Jayantilal Arya  Senior Resident General Surgery, GMC Shahdol Shahdol, Madhya Pradesh, India

DOI:

https://doi.org/10.32628/IJSRST52310253

Keywords:

CDH, Congenital Diaphragmatic Hernia

Abstract

Introduction= A congenital diaphragmatic hernia (CDH) occurs when the abdominal contents protrude into the thoracic cavity through an opening in the diaphragm due to the maldevelopment or defective fusion of the pleuroperitoneal membranes between the eighth and tenth week of fetal life during the embryonic development. Delayed diagnosis led to life-threatening complications such as bowel gangrene, tension gastrothorax and gastric volvulus. Such life-threatening conditions should be managed in emergently to avoiding misdiagnoses and untoward harm to the patient. Case presentation- We report a paediatric case of 11-year-old girls who presented with abdominal pain and distension, respiratory distress, chest pain, and non-bilious vomiting, constipation. He was initially diagnosed with tension pneumothorax, and the chest x-ray was interpreted as hydropneumothorax. A chest tube placement was planned but was withheld due to excessive vomiting. A nasogastric (NG) tube was inserted, and due to limited resources barium- radiography and CT scan not done. A diagnosis of a congenital diaphragmatic hernia with bowel obstruction was made. The left sided diaphragmatic hernia was repaired successfully with ileal perforation repair. Discussion- This case report highlights the importance of including a late-presenting CDH in the differential diagnoses of paediatric patients who present with abdominal pain and distension, respiratory distress, chest pain, and non-bilious vomiting, constipation, and radiological findings suggestive of hydropneumothorax. This pathology is infrequent in adults, among this age group, there are two different clinical presentations: asymptomatic patients who are diagnosed incidentally when abdominal organs are found in the thorax in a chest X-ray, and symptomatic patients due to side effects of incarceration, strangulation, haemorrhage and visceral perforation in the chest cavity.

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International Journal of Scientific Research in Science and Technology

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Published

2023-04-30

Issue

Volume 10, Issue 2, March-April-2023

Section

Research Articles

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[1]
Dr. Atul Kumar Khare, Dr. Ambuj Soni, Dr. Jayantilal Arya "Congenital Diaphragmatic Hernia- Rare Case at Rare Age Group with Atypical Presentation" International Journal of Scientific Research in Science and Technology(IJSRST), Online ISSN : 2395-602X, Print ISSN : 2395-6011,Volume 10, Issue 2, pp.399-404, March-April-2023. Available at doi : https://doi.org/10.32628/IJSRST52310253