18 May 2007
Late presenting diaphragmatic hernia: Clinical and diagnostic aspects
Urszula Zaleska-Dorobisz, Maciej Bagłaj, Dąbrówka Sokołowska, Jolanta Ładogórska, Krzysztof MorońMed Sci Monit 2007; 13(1): 137-146 :: ID: 482423
Abstract
Background: The congenital diaphragm hernia presents most frequently in the neonatal period. In a small group of children his defect can be diagnosed beyond the newborn age, during late infancy or early childhood. The late presenting congenital diaphragm hernia is characterized by a variable clinical picture and represents a considerable diagnostic challenge.
The aim of this study was to evaluate the usefulness of imaging methods in diagnosis, monitoring and management of late presenting diaphragmatic hernias.
Material and Methods: The retrospective analysis of 58 children with congenital diaphragm hernia, aged from 1 day to 7.5 years (the average: 2.6 years) treated between 1990–2006 in the Department of Pediatric Surgery and Urology of the Medical University of Wroclaw was carried out. 19 (39%) children in whom the malformation was recognized beyond the newborn period were numbered to this group. The detailed analysis comprised the type of clinical manifestation, as well as the therapeutic and diagnostic algorithm.
Results: The postero-lateral variant of the defect was recognized in 15 children, the Morgagni type in 2 and the hiatal type in 2. Right-sided hernia was found in 4 children, whereas left-sided in 15. 8 infants with left hernia presented with dominant symptoms from the respiratory system; 3 infants – from the GI tract with delayed somatic growth. Among children over 1 year of age, 6 presented symptoms of respiratory origin and only 2 of gastrointestinal nature. Only one child showed associated congenital malformations. In all children the diagnosis was made on the basis of imaging modalities. The GI contrast study was decisive imaging method in 14 children, ultrasonography in 15, CT in 4.
Conclusions: The lack of typical clinical presentation in cases of late presenting CDH leads to delayed diagnosis of the defect. This clinical entity should be however taken into account in the differential diagnosis of children with respiratory distress and GI disturbances. The imaging studies are essentials in every case.
Keywords: Child, Preschool, Child, Diagnostic Imaging, Hernia, Diaphragmatic - surgery, Infant, Newborn
Editorial
01 April 2024 : Editorial
Editorial: Forty Years of Waiting for Prevention and Cure of HIV Infection – Ongoing Challenges and Hopes for Vaccine Development and Overcoming Antiretroviral Drug ResistanceDOI: 10.12659/MSM.944600
Med Sci Monit 2024; 30:e944600
In Press
05 Mar 2024 : Clinical Research
Role of Critical Shoulder Angle in Degenerative Type Rotator Cuff Tears: A Turkish Cohort StudyMed Sci Monit In Press; DOI: 10.12659/MSM.943703
06 Mar 2024 : Clinical Research
Comparison of Outcomes between Single-Level and Double-Level Corpectomy in Thoracolumbar Reconstruction: A ...Med Sci Monit In Press; DOI: 10.12659/MSM.943797
21 Mar 2024 : Meta-Analysis
Economic Evaluation of COVID-19 Screening Tests and Surveillance Strategies in Low-Income, Middle-Income, a...Med Sci Monit In Press; DOI: 10.12659/MSM.943863
10 Apr 2024 : Clinical Research
Predicting Acute Cardiovascular Complications in COVID-19: Insights from a Specialized Cardiac Referral Dep...Med Sci Monit In Press; DOI: 10.12659/MSM.942612
Most Viewed Current Articles
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952