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Incarcerated congenital diaphragmatic hernias with bowel obstruction (Bochdalek)
Insights
Incarcerated congenital diaphragmatic hernias can cause bowel obstruction in children. Suspect this rare condition in children with respiratory illness, vomiting, and X-ray signs of obstruction.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Radiology
Background:
- Congenital diaphragmatic hernia (CDH) is a rare condition.
- Incarcerated CDH can lead to bowel obstruction in pediatric patients.
- Diagnosis can be challenging.
Observation:
- Three cases of incarcerated CDH causing bowel obstruction were treated over three years.
- One case involved strangulation requiring bowel resection.
- Two cases involved incarceration without strangulation.
Findings:
- The triad of upper respiratory illness (URI) or infiltrate on chest X-ray, vomiting, and X-ray evidence of bowel obstruction suggests incarcerated CDH.
- Early diagnosis is crucial for appropriate management.
Implications:
- This condition requires a high index of suspicion in pediatric patients presenting with specific symptoms.
- Prompt diagnosis and surgical intervention can prevent complications like bowel resection.
- Further research into diagnostic markers for incarcerated CDH is warranted.
Abstract:
Incarcerated congenital diaphragmatic hernias are a rare cause of bowel obstruction in children. In the past 3 yr, we have treated three such diaphragmatic hernias: the first incarcerated and strangulated requiring bowel resection while the other two were incarcerated only. The difficulty in diagnosing this condition in illustrated by these cases. In all children with the triad of upper respiratory illness (URI) or infiltrate on chest x-ray, vomiting, and x-ray evidence of bowel obstruction, the diagnosis of congenital diaphragmatic hernia (CDH) with incarceration and bowel obstruction should be entertained.