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Scholarly Commons > HCA Healthcare Journal > Vol. 2 > Iss. 3 (2021)

 

Keywords

neonate; diaphragmatic hernias; congenital diaphragmatic hernias; congenital abnormalities; internal hernia; Bochdaleck hernia; diagnosis

Disciplines

Critical Care | Gastroenterology | Pediatrics

Abstract

Introduction

Congential diaphragmatic hernias (CDH) are a rare process that have a prevalence of 1–4 cases per 10,000 live births, and of these, bilateral Bochdalek congenital diaphragmatic hernias are even rarer entities that occur in about 1% of cases. This finding is rarely documented in literature. This paper offers a detailed methodical timeline documentation of the events that occurred after delivery and includes how to approach the diagnosis and management of such a rare and volatile condition.

Presentation

The neonate was born at 35 weeks and 6 days gestation. Unfortunately, despite intensive cardiopulmonary resuscitation efforts, the neonate expired within less than one hour after delivery. Diagnosis of a bilateral diaphragmatic Bochdalek hernia was confirmed during the autopsy report and was evidenced by chest x-rays and clinical course. The autopsy revealed pulmonary aplasia/hypoplasia with weight being 12.8% of normal lung weight. Hepatomegaly, splenomegaly, nephromegaly and abdominal contents were in the bilateral pleural cavities.

Conclusion

This case report can be used to guide health care practitioners who come across neonates presenting with possible signs and symptoms of a rare but severe case of bilateral CDH. Management with enhanced prenatal care and hospital resources is needed to improve the chances of successful resuscitation in a neonate that presents with bilateral CDH.

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