Adv Pediatr Surg.  2020 Jun;26(1):11-14. 10.13029/aps.2020.26.1.11.

Diagnostic Considerations of Late Presenting Congenital Diaphragmatic Hernia in Children: Single Center Experience

• Shin HB
• Jeong YJ

• KMID: 2525492
• DOI: http://doi.org/10.13029/aps.2020.26.1.11

Abstract

Purpose
Late presenting congenital diaphragmatic hernia (CDH) in children has various clinical manifestations and serious pitfalls in diagnosis, which make differentiation very difficult. Thus, we intended to identify the clinical manifestations and to build the proper strategy of diagnostic imaging for late presenting CDH on the base of our institutional experience.
Methods
We performed a retrospective review of medical records for 6 patients who received the operation for late presenting CDH from December 2003 to March 2018 in our hospital.
Results
The range of age was 55 days to 13 years and the ratio of sex (male:female) was 2:1. The most common symptom was vomiting, followed by abdominal pain, chest discomfort, dyspnea, and cyanosis. As an initial diagnostic imaging study, chest X-ray was performed in all patients, of whom one patient checked it after the insertion of a gavage tube. As a secondary additional imaging study, chest computed tomography (CT) was performed in 4 patients, abdominal ultrasonography was performed in 2 patients, and chest magnetic resonance imaging, abdominopelvic CT, renal scan were each carried out for 1 patient.
Conclusion
If late presenting CDH is suspected in initial chest X-ray of patient who has gastrointestinal or respiratory symptoms, chest X-ray after insertion of a nasogastric tube or additional imaging study such as chest CT should be checked.

Keyword

Congenital diaphragmatic hernias; Child; Diagnosis; X-ray; Computed tomography