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Revista de la Facultad de Medicina (México)
On-line version ISSN 2448-4865Print version ISSN 0026-1742
Abstract
REAL-MACHAIN, Valeria del; BOLANOS-PANO, Luis Octavio; PARRA-IBARRARAN, Arianna and MERCADO-CRUZ, Eduardo. Late Presentation Congenital Diaphragmatic Hernia: Case Report with Literature Review. Rev. Fac. Med. (Méx.) [online]. 2023, vol.66, n.4, pp.26-34. Epub Sep 08, 2023. ISSN 2448-4865. https://doi.org/10.22201/fm.24484865e.2023.66.4.04.
A congenital diaphragmatic hernia occurs when the diaphragm has a structural defect that allows the migration of abdominal organs into the chest cavity. It is called late presentation when its diagnosis does after 30 days of life.
More than 60% of patients with congenital diaphragmatic hernia are misdiagnosed. The most common misdiagnoses are pleural effusion, pneumonia, pneumothorax, pneuma tocele, and lung abscess.
We present a case of a 3-year-old female who attended the emergency room due to abdominal pain, nausea, vomiting, intolerance to the oral route, and respiratory distress. The chest X-ray showed migration of the gastric chamber towards the thorax, displacement of the cardiac silhouette and the mediastinal structures to the right, and the tip of the nasogastric tube located in the left hemithorax. The doctors concluded a late presentation diaphragmatic hernia. The patient received surgical treatment, which was successful.
This paper highlights the importance of suspecting the diagnosis of late-onset congenital diaphragmatic hernia when treating pediatric patients with respiratory distress without another apparent cause, abdominal pain, nausea, and vomiting.
Keywords : Late-onset congenital diaphragmatic hernia; res piratory distress syndrome; acute abdominal pain; pediatrics.