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Late-presenting congenital diaphragmatic hernia with tension gastrothorax: a case series

Introduction: Congenital diaphragmatic hernia (CDH) is commonly diagnosed during neonatal period, however they may be detected at a later age with various clinical manifestation. We share 3 cases of tension gastrothorax as a manifestation of late-onset CDH. Case summary: Case 1: A 10-month-old...

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Main Authors: Mohamed Nahrudin, Khairoon Diyana, Ab. Rahman, Norhafiza, Othman, Mohd Yusran, Abdullah, Mohd Yusof
Format: Conference or Workshop Item
Language:English
English
Published: 2022
Subjects:
R Medicine (General)
RD Surgery
RJ Pediatrics
Online Access:http://irep.iium.edu.my/98233/1/CASESERIESPOSTERAGM2022edited24thMay%20%282%29.pdf
http://irep.iium.edu.my/98233/13/98233_Late-presenting%20congenital%20diaphragmatic%20hernia%20with%20tension.pdf
http://irep.iium.edu.my/98233/
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spelling my.iium.irep.982332022-06-09T01:54:16Z http://irep.iium.edu.my/98233/ Late-presenting congenital diaphragmatic hernia with tension gastrothorax: a case series Mohamed Nahrudin, Khairoon Diyana Ab. Rahman, Norhafiza Othman, Mohd Yusran Abdullah, Mohd Yusof R Medicine (General) RD Surgery RJ Pediatrics Introduction: Congenital diaphragmatic hernia (CDH) is commonly diagnosed during neonatal period, however they may be detected at a later age with various clinical manifestation. We share 3 cases of tension gastrothorax as a manifestation of late-onset CDH. Case summary: Case 1: A 10-month-old boy presented with worsening respiratory distress requiring intubation. Chest radiograph revealed a huge lucency in the left hemithorax with mediastinal shift which improved after nasogastric tube insertion. CT thorax confirmed the diagnosis of left CDH. Laparotomy revealed 5x6 cm posterolateral defect was seen, content completely reduced and the defect was primarily repaired. Case 2: A 22-month-old baby boy presented with rapid breathing with reduced air entry on the left side. Chest radiograph revealed a lucent left hemithorax causing mediastinal shift. Patient was misdiagnosed as tension pneumothorax and tube thoracostomy was performed in emergency department. CT thorax confirmed presence of CDH and surgical referral was made for primary repair. No stomach injury due to chest tube insertion was seen. Case 3: A 12-month-old boy presented with abdominal pain and intractable crying. Chest X-ray suggestive of CDH. Ultrasound assessment showed a suspicion of left CDH with gastric volvulus. Hence, emergency laparotomy was performed . Content was reduced completely and healthy. Primary repair was performed. Conclusion: Late-onset CDH with a tension gastrothorax must be recognised and managed promptly to relief the mediastinal shift. Misdiagnosis of a tension pneumothorax poses a risk of stomach perforation following tube thoracotomy. Suspicion of gastric volvulus otherwise requires an urgent exploration. 2022-06-04 Conference or Workshop Item NonPeerReviewed application/pdf en http://irep.iium.edu.my/98233/1/CASESERIESPOSTERAGM2022edited24thMay%20%282%29.pdf application/pdf en http://irep.iium.edu.my/98233/13/98233_Late-presenting%20congenital%20diaphragmatic%20hernia%20with%20tension.pdf Mohamed Nahrudin, Khairoon Diyana and Ab. Rahman, Norhafiza and Othman, Mohd Yusran and Abdullah, Mohd Yusof (2022) Late-presenting congenital diaphragmatic hernia with tension gastrothorax: a case series. In: Malaysian Association of Paediatric Surgery 1st Annual Scientific Meeting, 4 Jun 2022, Putrajaya, Malaysia. (Unpublished)
institution Universiti Islam Antarabangsa Malaysia
building IIUM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider International Islamic University Malaysia
content_source IIUM Repository (IREP)
url_provider http://irep.iium.edu.my/
language English
English
topic R Medicine (General)
RD Surgery
RJ Pediatrics
spellingShingle R Medicine (General)
RD Surgery
RJ Pediatrics
Mohamed Nahrudin, Khairoon Diyana
Ab. Rahman, Norhafiza
Othman, Mohd Yusran
Abdullah, Mohd Yusof
Late-presenting congenital diaphragmatic hernia with tension gastrothorax: a case series
description Introduction: Congenital diaphragmatic hernia (CDH) is commonly diagnosed during neonatal period, however they may be detected at a later age with various clinical manifestation. We share 3 cases of tension gastrothorax as a manifestation of late-onset CDH. Case summary: Case 1: A 10-month-old boy presented with worsening respiratory distress requiring intubation. Chest radiograph revealed a huge lucency in the left hemithorax with mediastinal shift which improved after nasogastric tube insertion. CT thorax confirmed the diagnosis of left CDH. Laparotomy revealed 5x6 cm posterolateral defect was seen, content completely reduced and the defect was primarily repaired. Case 2: A 22-month-old baby boy presented with rapid breathing with reduced air entry on the left side. Chest radiograph revealed a lucent left hemithorax causing mediastinal shift. Patient was misdiagnosed as tension pneumothorax and tube thoracostomy was performed in emergency department. CT thorax confirmed presence of CDH and surgical referral was made for primary repair. No stomach injury due to chest tube insertion was seen. Case 3: A 12-month-old boy presented with abdominal pain and intractable crying. Chest X-ray suggestive of CDH. Ultrasound assessment showed a suspicion of left CDH with gastric volvulus. Hence, emergency laparotomy was performed . Content was reduced completely and healthy. Primary repair was performed. Conclusion: Late-onset CDH with a tension gastrothorax must be recognised and managed promptly to relief the mediastinal shift. Misdiagnosis of a tension pneumothorax poses a risk of stomach perforation following tube thoracotomy. Suspicion of gastric volvulus otherwise requires an urgent exploration.
format Conference or Workshop Item
author Mohamed Nahrudin, Khairoon Diyana
Ab. Rahman, Norhafiza
Othman, Mohd Yusran
Abdullah, Mohd Yusof
author_facet Mohamed Nahrudin, Khairoon Diyana
Ab. Rahman, Norhafiza
Othman, Mohd Yusran
Abdullah, Mohd Yusof
author_sort Mohamed Nahrudin, Khairoon Diyana
title Late-presenting congenital diaphragmatic hernia with tension gastrothorax: a case series
title_short Late-presenting congenital diaphragmatic hernia with tension gastrothorax: a case series
title_full Late-presenting congenital diaphragmatic hernia with tension gastrothorax: a case series
title_fullStr Late-presenting congenital diaphragmatic hernia with tension gastrothorax: a case series
title_full_unstemmed Late-presenting congenital diaphragmatic hernia with tension gastrothorax: a case series
title_sort late-presenting congenital diaphragmatic hernia with tension gastrothorax: a case series
publishDate 2022
url http://irep.iium.edu.my/98233/1/CASESERIESPOSTERAGM2022edited24thMay%20%282%29.pdf
http://irep.iium.edu.my/98233/13/98233_Late-presenting%20congenital%20diaphragmatic%20hernia%20with%20tension.pdf
http://irep.iium.edu.my/98233/
_version_ 1735386644103561216
score 13.211869

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