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[Abdominal pain and vomiting: a 4-year old boy with relaxation of diaphragm]

M E Pragt-Weijer1, R J Thunnissen, Z J de Langen

  • 1Afd. Kindergeneeskunde, Martini Ziekenhuis, Groningen.

Nederlands Tijdschrift Voor Geneeskunde
|August 30, 2001
PubMed

Insights

A rare case of diaphragm relaxation in a child led to gastric volvulus and abdominal issues. Surgical repair of the diaphragm and organ repositioning resulted in a full recovery.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Thoracic Surgery

Background:

  • Diaphragm relaxation, a rare condition, can be congenital or acquired.
  • It is characterized by an intact but hypoplastic diaphragm, leading to an elevated diaphragm.
  • Unlike congenital diaphragmatic hernia, the diaphragm remains anatomically intact.

Observation:

  • A 4-year-old boy presented with vomiting, abdominal pain, and a left upper abdominal swelling.
  • Symptoms included a week of general malaise and prolonged constipation.
  • Radiological imaging showed a large air-fluid collection in the upper abdomen and chest.

Findings:

  • Surgical exploration revealed gastric volvulus (twisting of the stomach).
  • An elevated and hypoplastic diaphragm was identified as the cause.
  • The intra-abdominal organs were displaced into the thoracic cavity.

Implications:

  • Surgical plication of the diaphragm and repositioning of intra-abdominal organs successfully treated the condition.
  • This case highlights the importance of recognizing diaphragm relaxation in pediatric patients with gastrointestinal and respiratory symptoms.
  • Prompt surgical intervention can lead to excellent outcomes in cases of gastric volvulus secondary to diaphragm relaxation.

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