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Delayed-onset Bochdalek hernia in a 3-year-old child
1Department of Emergency Medicine, East Carolina University School of Medicine/Pitt County Memorial Hospital, Greenville, NC 27858-4354.
Insights
A 3-year-old child experienced sudden breathing difficulties due to a Bochdalek diaphragmatic hernia. Early recognition and surgical repair led to an uneventful recovery, highlighting the importance of diagnosing this rare condition.
Area of Science:
- Pediatric Surgery
- Congenital Abnormalities
- Emergency Medicine
Background:
- Congenital diaphragmatic hernia (CDH) is a rare birth defect.
- While often diagnosed neonatally, late-onset presentations can occur.
- Bochdalek hernias are the most common type of CDH.
Observation:
- A previously healthy 3-year-old presented with acute shortness of breath and wheezing.
- Chest X-ray revealed findings consistent with a diaphragmatic hernia.
- The patient had no prior neonatal complications.
Findings:
- Surgical exploration confirmed a Bochdalek diaphragmatic hernia.
- The child underwent successful surgical repair.
- Postoperative recovery was uneventful.
Implications:
- This case underscores the importance of considering late-onset CDH in pediatric respiratory distress.
- Prompt diagnosis and surgical intervention are crucial for favorable outcomes.
- Understanding the differential diagnosis of CDH aids in timely management of this correctable condition.
Abstract:
A 3-year-old child presented to the emergency department (ED) with the sudden onset of shortness of breath and wheezing. The child had previously been in good health and had no problems during the neonatal period. Chest x-ray performed in the ED was consistent with a Bochdalek diaphragmatic hernia. Subsequently, the child had surgery. The diagnosis was confirmed, and recovery was uneventful. The differential diagnosis of late onset congenital diaphragmatic hernia is discussed with an emphasis on both early recognition and differential diagnosis of this rare but correctable entity.
