Later Age Diaphragmatic Hernia

Česká verzia

Authors: M. Fuňáková; V. Cingel; J. Trnka; J. Babala; M. Babulic; J. Hornová ^*; F. Horn
Authors place of work: Klinika detskej chirurgie LF UKo a DFNsP, Bratislava, Slovenská republika, prednosta: MUDr. J. Trnka, CSc. ; I. detská klinika LF UKo a DFNsP, Bratislava, Slovenská republika, prednostka: doc. MUDr. O. Červeňová, CSc. ^*
Published in the journal: Rozhl. Chir., 2008, roč. 87, č. 10, s. 554-558.
Category: Monothematic special - Original

Summary

Introduction:
Congenital diaphragmatic hernia (CDH) is usually diagnosed antenatally or through the neonatal period at present. It is also used to treat and manage CDH in this date. However in rare cases CDH could be presented after finished neonatal period with non-specific and misleading symptoms. The aim of our presentation is to analyze the patients with late – presenting and diagnosed CDH.

Methods:
During period 1996–2006 we operated on 54 children with CDH, 12 of them with late – presenting CDH, age variance was 9 months and 6 years. The spectrum of symptoms was from asymptomatic CDH (2 patients), mild respiratory (4 patients) and gastrointestinal symptoms (4 patients), combination of respiratory and gastrointestinal symptoms (2 patients) and finally the symptomatology of bowel incarceration (2 patients).

Results:
Seven children presented with another associated malformations (m. Down, congenital heart failure, hydrocephalus, anorectal atresia). All 12 patients were operated on with a good results. The operation was composed of reposition of the herniated part of gastrointestinal tract (without need of resection) and diaphragmatic plastic. Two patients were reoperated on – once because of diaphragmatic relaxation and the second one due to consecutive heart operation.

Conclusion:
Congenital diaphragmatic hernia could be presented with chronic and non-specific respiratory or gastrointestinal symptoms. Time to time, presentation of diaphragmatic hernia as “acute abdomen” could be seen. The operation is indicated, also in asymptomatic patients as a prevention of life-threating events.

Key words:
congenital diaphragmatic hernia – hernia of Bochdaleki – Morgani hernia – late clinical manifestation

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