Bilateral Congenital Diaphragmatic Hernia with Delayed Diagnosis

Introduction

Congenital diaphragmatic hernia (CDH) occurs in 1 in 2500 live births and in 85% of cases the defect is left-sided. This congenital anomaly can almost always be picked up with prenatal ultrasound screening.

Bilateral hernia is extremely rare, and accounts for 2% of CDH.[1] The survival in the few reported cases is less than 30%, and that results from the greater lung hypoplasia and the greater likelihood of associated anomalies.[2] [3]

The authors present a case of a child with bilateral CDH undetected during gestation and early newborn period. The diagnosis was made in stages, during a prolonged intensive care unit stay.

The diagnosis of the right defect was deferred until 3 weeks after birth, after protracted respiratory pathology and following treatment forStreptococcus agalactiae sepsis. The left defect was diagnosed during a relaparotomy for jaundice and exploration of the bile ducts. The authors describe the diagnostic work-up and the management that resulted in an unexpectedly favorable outcome.

• References

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