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Intestinal Perforation during the Stabilization Period in a Preterm Infant with Congenital Diaphragmatic Hernia
Zbyněk Straňák1,2, Karel Pýcha3, Simona Feyereislova1,2
1Third Faculty of Medicine, Charles University, Prague, Czech Republic.
European Journal of Pediatric Surgery Reports
|September 5, 2017
Summary
Delayed surgery for congenital diaphragmatic hernia (CDH) may pose risks. This case highlights that intestinal perforation and early surgical intervention should be considered in deteriorating neonates with CDH.
Area of Science:
- Neonatal surgery
- Pediatric surgery
- Critical care medicine
Background:
- Delayed surgical repair is a common strategy for infants with congenital diaphragmatic hernia (CDH).
- Limited evidence supports delayed repair over immediate intervention.
- This study addresses a rare complication in a very low-birth-weight infant.
Observation:
- A neonate with prenatally diagnosed left-sided CDH developed transmural bowel perforations within the postnatal stabilization period.
- The infant experienced bowel dilation on the second day of life.
- Complications included meconium pleuroperitonitis, severe systemic inflammatory response syndrome, pulmonary hypertension, and multiple organ failure.
Findings:
- Unexpected transmural bowel perforations occurred during the stabilization phase in a very low-birth-weight infant with CDH.
- The infant's condition rapidly deteriorated, leading to fatal complications.
- Intestinal perforation was a critical, life-threatening event in this CDH case.
Implications:
- Early surgical intervention should be considered for neonates with CDH who show signs of deterioration.
- This case underscores the potential risks of delayed surgery in specific CDH presentations.
- Further research is needed to refine surgical timing strategies for congenital diaphragmatic hernia.
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