Unusual Presentation of Congenital Diaphragmatic Hernia-Anaesthetic Consideration
PDF Downloads : 5    VIEW PDF


Congenital diaphragmatic hernia
Bochdalek type

How to Cite

Pandey , D. A. K., Rawat, D. H. S., & Dr. Mikkilineni J. (2016). Unusual Presentation of Congenital Diaphragmatic Hernia-Anaesthetic Consideration. VIMS Health Science Journal , 3(1), 25-27. Retrieved from https://vimshsj.edu.in/index.php/main/article/view/130


Congenital diaphragmatic hernia (CDH) is herniation of bowels and abdominal solid organs in thoracic cavity, causing pulmonary hypoplasia with decreased pulmonary vasculature and dysfunction of the surfactant system. In severe cases, left ventricular hypoplasia us also observed. Delayed herniation the abdominal contents through a congenital diaphragmatic hernia may occur beyond the neonatal period. CDH occurs in about 1 in 2000 births. The most common defect is the posterolateral (Bochdalek) type. Over 90% of the patients will be diagnosed either antenatally or will present with respiratory distress in the first few hours of life. In these cases there are few diagnostic problems. There is a significant mortality associated with this group. However about 5% to 30% of diaphragmatic hernias present beyond the neonatal period. Although the mortality in this group is low, the morbidity may be significant. The late presenting congenital diaphragmatic hernia poses considerable diagnostic and anaesthetic challenges because of its varied presentation often resulting in diagnostic delay, inappropriate treatment and potential fatal outcome. We report the successful anaesthetic management of a 9 month old infant who was planned to be operated for tension pneumothorax and finally diagnosed as CDH intraoperatively.

PDF Downloads : 5    VIEW PDF


Davenport M, Holmes K. Current management of congenital diaphragmatic hernia. Br J Hosp Med 1995;53:95-101.

Gleeson F, Spitz L. Pitfalls in the diagnosis of congenital diaphragmatic hernia. Arch Dis Child 1991;66:670-1.

Berman L, Stringer D, Ein SH, et al. The late presenting paediatric Bochdalek hernia: a 20 – year review. J Pediatr Surg 1988;23:735-9

Elhalaby EA, Abo Sikeena MH. Delayed presentation of congenital diaphragmatic hernia. Pediatr Surg Int 2002;18:480-5.

Baglaj M, Dorobisz U. Late-presenting congenital diaphragmatic hernia in children: a literature review. Pediatr Radiol 2005;35: 478-88.

Fein JA, Loiselle J, Eberlein S, et al. Diaphragmatic hernia masquerading as pneumothorax in two toddlers. Ann Emerg Med 1993;22:1221-4.

Snyder HS, Salo DF, Kelly PH. Congenital diaphragmatic hernia presenting as massive gastrothorax. Ann Emerg Med 1990;19:562-4.

Coren ME, Rosenthal M, Bush A. Congenital diaphragmatic hernia misdiagnosed as tension pneumothorax. Pediatr Pulmonol 1997;24:119-21.

Oh KS, Newman B, Bender TM, et al. Radiological evaluation of the diaphragm. Radiol Clin North Am 1988;26:355-64.

Craigie RJ, Mullassery D, Kenny SE. Laparoscopic repair of late presenting congenital diaphragmatic hernia. Hernia 2007;11(1):79-82.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.


Download data is not yet available.