Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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A Case of Late Presenting Congenital Diaphragmatic Hernia

늦게 발현된 선천성 횡경막 탈장 1예

  • Song, Ji-Eun (Department of Pediatrics, College of Medicine, Hallym University) ;
  • Kwon, Oh-Kun (Department of Pediatrics, College of Medicine, Hallym University) ;
  • Kim, Young-Ho (Department of Pediatrics, College of Medicine, Hallym University) ;
  • Lee, Hae-Ran (Department of Pediatrics, College of Medicine, Hallym University)
  • 송지은 (한림대학교 의과대학 소아과학교실) ;
  • 권오건 (한림대학교 의과대학 소아과학교실) ;
  • 김영호 (한림대학교 의과대학 소아과학교실) ;
  • 이혜란 (한림대학교 의과대학 소아과학교실)
  • Received : 2009.07.02
  • Accepted : 2009.09.03
  • Published : 2009.09.30
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Abstract

Congenital diaphragmatic hernias (CDH) usually cause respiratory distress soon after birth and are associated with a high mortality rate in the early postnatal period. However, there is a milder form of CDH that does not manifest during the neonatal period. The late presenting CDH is characterized by a variable clinical picture. We present the case of an otherwise healthy 5-month-old girl, who was referred for evaluation of an 1-day history of vomiting and irritability. Chest simple X-ray and CT showed bowel loops in the left thoracic cavity, which was consistent with diaphragmatic hernia. At operation, she was found to have a small left posterolateral diaphagmatic defect with viable small bowel loops in the left thoracic cavity. After surgical reposition of the hernia, the symptoms such as vomiting and irritability subsided. The lack of typical manifestation of CDH such as respiratory distress may lead to delayed diagnosis. The possibility of late presenting CDH should not be overlooked even after the neonatal period.

평소 건강하게 지내다가 갑자기 시작된 반복적인 구토와 보채는 증상으로 5개월 여아가 병원에 내원하였고, 단순 흉부 방사선 검사에서 비정상적 음영이 좌측 흉부에서 관찰되었다. 이어 시행된 흉부 전산화 단층촬영에서 선천성 횡경막 탈장으로 진단되어, 흉부외과에서 수술적 치료 시행하였으며 수술 결과 횡경막 좌측후외방의 Bochdalek 형식의 선천성 횡격막 탈장으로 확인되었고, 수술적 치료 후 증상의 호전을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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