18 May 2007
Med Sci Monit 2007; 13(1): 137-146 :: ID: 482423
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
04 June 2022 : EditorialEditorial: Acute Hepatitis of Unknown Origin in Children. Is Autoimmunity at Play?
Med Sci Monit 2022; 28:e937371
27 June 2022 : Clinical ResearchShoulder Injury Related to Vaccine Administration (SIRVA) in 16 Patients Following COVID-19 Vaccination Who...
Med Sci Monit In Press; DOI: 10.12659/MSM.937430
04 June 2022 : Clinical ResearchScreening for SARS-CoV-2 Infection in Students at the Medical University of Warsaw, Poland Between November...
Med Sci Monit 2022; 28:e936962
30 May 2022 : Clinical ResearchEffects of Wearing Face Masks on Exercise Capacity and Ventilatory Anaerobic Threshold in Healthy Subjects ...
Med Sci Monit 2022; 28:e936069
28 Jun 2022 : Meta-AnalysisUrodynamics in Early Diagnosis of Diabetic Bladder Dysfunction in Women: A Systematic Review and Meta-Analysis
Med Sci Monit In Press; DOI: 10.12659/MSM.937166
28 Jun 2022 : Clinical ResearchSerum Calprotectin – a NET Product – as a Biomarker of Disease Activity in Patients with Systemic Lupus Ery...
Med Sci Monit In Press; DOI: 10.12659/MSM.936534
28 Jun 2022 : Database AnalysisLINC00963 May Be Associated with a Poor Prognosis in Patients with Cervical Cancer
Med Sci Monit In Press; DOI: 10.12659/MSM.935070
Most Viewed Current Articles
30 Dec 2021 : Clinical ResearchRetrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...
Med Sci Monit 2021; 27:e935379
08 Mar 2022 : Review articleA Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...
Med Sci Monit 2022; 28:e936292
01 Nov 2020 : Review articleLong-Term Respiratory and Neurological Sequelae of COVID-19
Med Sci Monit 2020; 26:e928996