Congenital diaphragmatic hernia presenting due to gastrointestinal complications

Peter B. Manning, J. Patrick Murphy, Stephen C. Raynor, Keith W. Ashcraft

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

Congenital diaphragmatic hernia (CDH) presents beyond the first hours of life in 10% to 20% of cases. Presenting symptoms may be quite nonspecific, and are often gastrointestinal rather than respiratory in origin. We have recently had experience with five such cases, one in a newborn and four in older children. All presented with symptoms related to gastrointestinal complications of their diaphragmatic defect. In the newborn, gastric perforation had occurred, a complication of this anomaly not previously reported. The chest radiograph showed loops of bowel in the chest in all cases, allowing correct preoperative diagnoses. Urgent operative intervention was undertaken in each case with good results and no long-term morbidity. The risk of intestinal strangulation in the late-presenting CDH patient warrants emergent surgical management, which should be rewarded by uniform survival with few complications. Although preoperative stabilization may decrease the severity of pulmonary vasospasm in the newborn with respiratory failure, delay may increase the risk of bowel infarction in the older child presenting with gastrointestinal symptoms.

Original languageEnglish (US)
Pages (from-to)1225-1228
Number of pages4
JournalJournal of pediatric surgery
Volume27
Issue number9
DOIs
StatePublished - Sep 1992

Keywords

  • Congenital diaphragmatic hernia
  • bowel obstruction
  • gastric perforation

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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