Brouard J, Leroux P, Jokic M, Maguer D, Chevet J B, Ravasse P
Service de pédiatrie A, centre hospitalier et universitaire de Caen, France.
Arch Pediatr. 2000 Mar;7 Suppl 1:48S-51S. doi: 10.1016/s0929-693x(00)88819-3.
Two patients, aged four and six months, with congenital diaphragmatic hernias, and who presented outside of the neonatal period, are reported. Clinical presentation was a progressive respiratory failure, and radiographic findings showed a consolidation of the left lung, associated with a pneumothorax in one and an ascites in the other. One had previous normal chest X-rays. All cases with herniated bowel showed connecting bowel segments passing through the diaphragmatic defect. All were repaired via an abdominal approach. Delay in presentation of congenital diaphragmatic hernias is not uncommon. Long-term prognosis is favourable and postoperative morbidity is minimal, despite late presentation and undesirable time delay between first sign and surgery.
报告了两名年龄分别为4个月和6个月的先天性膈疝患者,他们在新生儿期以外发病。临床表现为进行性呼吸衰竭,影像学检查结果显示左肺实变,其中一例伴有气胸,另一例伴有腹水。其中一例之前胸部X光检查正常。所有疝出肠管的病例均显示连接肠段穿过膈肌缺损。所有病例均通过腹部入路进行修复。先天性膈疝出现延迟并不罕见。尽管出现较晚且首发症状与手术之间存在不必要的时间延迟,但长期预后良好,术后发病率极低。