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Accessory septum transversum. The first case report.

R Krzyzaniak, S W Gray

    The American Surgeon
    |May 1, 1986
    PubMed
    Summary
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    A rare congenital anomaly, septum transversum duplication, caused respiratory distress in a newborn. Surgical plication of the diaphragm was attempted, potentially improving function in this unique case.

    Area of Science:

    • Developmental biology
    • Neonatal surgery
    • Congenital anomalies

    Background:

    • Respiratory distress in newborns can stem from various causes, including diaphragmatic abnormalities.
    • Congenital anomalies of the diaphragm, such as septum transversum duplication, are rare and present diagnostic challenges.

    Observation:

    • A newborn presented with respiratory distress, initially suspected as diaphragmatic paralysis.
    • Surgical exploration revealed a duplicated septum transversum, which was mistaken for the diaphragm.
    • The anomalous septum transversum was surgically plicated, along with a redundant central tendon.

    Findings:

    • The surgical plication of the anomalous septum transversum was performed via a transabdominal approach.
    • The redundant central tendon of the diaphragm was also addressed during the procedure.

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  • The intervention may have contributed to improved respiratory function in the neonate.

    • Implications:

    • This case highlights the importance of considering rare embryological variations in neonatal respiratory distress.
    • Reviewing diaphragm embryology and correlating it with autopsy findings is crucial for understanding such anomalies.
    • A novel surgical approach for potential correction of septum transversum duplication is proposed.