Congenital diaphragmatic hernia

Case contributed by Assoc Prof Frank Gaillard

Presentation

Respiratory distress.

Patient Data

Age: Neonate

X-ray of a neonate demonstrates the left hemithorax to be filled with multiple radiolucent regions, with displacement of the cardiac silhouette to the right. The nasogastric tube passes towards the left. Umbilical catheters are in situ. No convincing gas containing loops of bowel can be seen in the abdomen.

Case Discussion

This case demonstrates typical appearances of a congenital diaphragmatic hernia (Bochdalek hernia), and illustrates how important it is not to rely solely on the position of the nasogastric tube for the diagnosis. In this case the stomach remains in the abdominal cavity, but the small bowel is in the chest. 

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