Diaphragmatic hernia: respiratory distress in neonate

Case contributed by Townsville radiology training
Diagnosis certain

Presentation

Respiratory distress. Multiple attempts to cannulate umbilical artery and vein.

Patient Data

Age: 2 hours
Gender: Male

Large left diaphragmatic hernia demonstrated. Mediastinum and umbilical venous catheter shifted to the right, with catheter tip in right atrium. The umbilical artery is coiled. Two umbilical arterial lines are in place. One extends into the right side of the pelvis, the other appears to extend into the sciatic vein.

After diaphragm repair

x-ray

A large lung bud is present on the left. Large left pneumothorax and effusion noted.

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