Congenital diaphragmatic hernia

Case contributed by Ryan Thibodeau
Diagnosis certain

Presentation

Hypoxia.

Patient Data

Age: 20 days
Gender: Female
x-ray
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Info

There are multiple loops of air-filled bowel in the left hemithorax concerning for congenital diaphragmatic hernia, with little aeration of the left upper lobe. A prominent stomach bubble is seen within the left upper quadrant of the abdomen. There is right-sided volume loss likely secondary to significant rightward mediastinal shift from the bowel in the left hemithorax.

There is no significant pleural effusion or discernible pneumothorax.

Post-operative day 6

x-ray
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The lung volumes are low-normal. However, there is no evidence of recurrent congenital diaphragmatic hernia.

Case Discussion

This is a case of left-sided congenital diaphragmatic hernia. The patient was taken to the operating room where it was found that the majority of the large bowel and the entire small bowel were in the patient's chest. This was brought back down to the abdomen and through the diaphragmatic defect, which was noted to encompass approximately the lateral half of the diaphragm. The patient's intestine was placed back into the peritoneal cavity.

Co-authors:
Camille Dumas, DO
Travis Bevington, MD

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