Congenital diaphragmatic hernia and ECMO

Case contributed by Dr Alexandra Stanislavsky

Presentation

Severe respiratory distress at birth.

Patient Data

Age: neonate
Gender: Male
X-ray

Chest x-ray obtained shortly after birth

Multiple bowel loops fill the right hemithorax, causing mediastinal shift to the left.

X-ray

The patient's x-rays remained relatively unchanged for 4 days. On day 5 the chest x-ray looked like this...

X-ray

One day later.

One day later, the pulmonary opacity has almost completely resolved.  There is a persistent pleural fluid collection on the right, and marked body wall oedema.

Case Discussion

This is a severe congenital diaphragmatic hernia with significant bilateral pulmonary hypoplasia.  The baby required ECMO on day 5 of life, and this case demonstrates the dramatic, but normal - and rapidly transient - pulmonary appearance secondary to ECMO.  

After a stormy start, the bub lived to go home from hospital.

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Case information

rID: 15695
Case created: 1st Nov 2011
Last edited: 10th Dec 2016
Systems: Chest, Paediatrics
Inclusion in quiz mode: Included

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