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The late presentation of postero-lateral congenital diaphragmatic hernias
N D Heaton1, G Adam, E R Howard
1Department of Surgery, King's College Hospital, Denmark Hill, London, UK.
Postgraduate Medical Journal
|June 1, 1992
Insights
Congenital postero-lateral diaphragmatic hernias can present later in infancy, not just neonatally. Early diagnosis and treatment of these diaphragmatic defects lead to excellent clinical outcomes.
Area of Science:
- Pediatric Surgery
- Neonatology
- Congenital Abnormalities
Background:
- Congenital diaphragmatic hernias (CDH) are a significant cause of respiratory distress in newborns.
- Posterolateral Bochdalek hernias are the most common type of CDH.
- Diagnosis is typically made antenatally or shortly after birth.
Observation:
- This study discusses four patients presenting after the neonatal period with symptoms suggestive of congenital postero-lateral diaphragmatic hernias.
- Symptoms included a combination of respiratory and gastro-intestinal issues.
- Late presentation of CDH is more frequent than previously recognized.
Findings:
- Late presentation of congenital postero-lateral diaphragmatic hernias is a notable clinical observation.
- The diagnostic signs included both respiratory and gastro-intestinal compromise.
- All four patients were successfully diagnosed and treated.
Implications:
- Increased awareness of late-presenting CDH is crucial for timely diagnosis.
- Prompt surgical intervention for diaphragmatic hernias, regardless of presentation age, is associated with favorable outcomes.
- This highlights the importance of considering CDH in infants with unexplained respiratory and GI symptoms beyond the neonatal period.
Abstract:
Four patients presenting after the neonatal period with a combination of respiratory and gastro-intestinal symptoms and signs which point to the diagnosis of congenital postero-lateral diaphragmatic hernias are discussed. Late presentation is more common than previously acknowledged. Early correct diagnosis and treatment are associated with an excellent clinical outcome.