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[Congenital diaphragmatic hernia presenting after the neonatal period]
Insights
Congenital diaphragmatic hernia (Bochdalek) is a rare birth defect. Early diagnosis and surgery, even in older children, improve outcomes for this condition.
Area of Science:
- Pediatric Surgery
- Congenital Malformations
- Neonatal Care
Context:
- Congenital diaphragmatic hernia (Bochdalek) is a significant congenital malformation with high neonatal mortality.
- Diagnosis after the neonatal period is uncommon, but prognosis is generally favorable.
- This study focuses on surgical outcomes in children diagnosed beyond the neonatal stage.
Purpose:
- To evaluate the surgical outcomes of congenital diaphragmatic hernia (Bochdalek) in children diagnosed after the neonatal period.
- To assess the impact of early surgical intervention on prognosis in this patient group.
Summary:
- Eleven children aged 6 months to 5.5 years with congenital diaphragmatic hernia (Bochdalek) were surgically treated.
- Nine patients presenting with respiratory symptoms underwent semi-elective surgery with excellent results.
- Two patients who presented with strangulation of incarcerated bowel died, highlighting the risk of delayed diagnosis and treatment.
Impact:
- Early diagnosis and surgical intervention are crucial for improving survival rates in congenital diaphragmatic hernia (Bochdalek).
- Even asymptomatic cases benefit from early surgery, as demonstrated by the favorable outcomes in the majority of patients.
- This research underscores the importance of considering congenital diaphragmatic hernia (Bochdalek) in older children presenting with respiratory issues or bowel obstruction.
Abstract:
Congenital diaphragmatic hernia (Bochdalek) is a congenital malformation usually presenting early after birth with a mortality of 50-70%. It is rarely diagnosed after the neonatal period, when the prognosis is considered favorable. We operated on 11 children past the neonatal period, ranging from 6 months to 5.5 years of age. 9 had presented with respiratory symptoms and were operated on semi-electively with excellent results. 2, operated on for strangulation of bowel incarcerated in the hernia, eventually died (aged 7 months and 1 year, respectively). Early diagnosis is important, as early surgery is recommended, even in those without symptoms.