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Late-presenting congenital diaphragmatic hernia: a rare and challenging diagnosis

Mariana Sebastião1, Mariana Gouveia Lopes2, Inês Pessanha3

  • 1Department of Pediatrics, ULS Coimbra, Coimbra, Portugal 12024@ulscoimbra.min-saude.pt.

BMJ Case Reports
|July 5, 2025
PubMed

Insights

This study highlights two rare pediatric cases of hiatal hernias, one with a simultaneous Morgagni hernia. Early diagnosis and surgical intervention led to favorable outcomes in both children.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Diagnostic Imaging

Background:

  • Hiatal hernias are uncommon in children.
  • Morgagni hernias are a rare type of congenital diaphragmatic hernia.
  • Simultaneous occurrence of hiatal and Morgagni hernias is exceptionally rare.

Purpose of the Study:

  • To report two uncommon pediatric cases of hiatal hernias.
  • To emphasize the importance of recognizing complex diaphragmatic defects.
  • To highlight the significance of early diagnosis and surgical management.

Main Methods:

  • Case report of two pediatric patients.
  • Diagnostic imaging including chest X-ray and CT scan.
  • Surgical correction of diaphragmatic hernias.

Main Results:

  • Case 1: Simultaneous hiatal and Morgagni hernias diagnosed and surgically corrected with good outcome.
  • Case 2: Large sliding gastric hiatal hernia diagnosed and surgically corrected with favorable outcome.
  • Both diagnoses were incidental findings.

Conclusions:

  • Early recognition and high index of suspicion are crucial for optimal outcomes in pediatric diaphragmatic hernias.
  • Surgical correction is effective for managing pediatric hiatal and Morgagni hernias.
  • Complex diaphragmatic defects require thorough diagnostic evaluation.

Keywords:
Gastrointestinal surgeryInfant healthPaediatric Surgery

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