Late presentation of congenital diaphragmatic hernia: a case report

Abstract

Delayed herniation of the abdominal contents through a congenital diaphragmatic hernia may occur beyond the neonatal period. This report describes a 9-week-old female baby who presented with excessive crying, irritability and respiratory distress secondary to late presentation of left-sided congenital diaphragmatic hernia. The chest radiograph showed tension gastrothorax. She underwent surgical reduction of the hernia. She made an excellent recovery and was discharged a few days after the operation. It is assumed that sudden increase of the intra-abdominal pressure caused herniation of abdominal content through a pre-existing diaphragmatic defect. This report aims to increase the awareness of this condition among physicians and pediatric surgeons to allow early diagnosis and management.

Keywords: Chest radiograph; Gastrothorax; Late presentation of diaphragmatic hernia; Respiratory distress.

Figure 1

Pre-operative image showing gastro thorax with coiled nasogastric tube on the left side of the chest.

Figure 2

Resolution of gastrothorax with normal lung fields.