Department of Pediatric Radiology, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0585, USA.
Pediatr Radiol. 2012 Mar;42(3):337-42. doi: 10.1007/s00247-011-2226-9. Epub 2011 Sep 3.
Imaging findings in delayed presentation of congenital diaphragmatic hernia can be confusing and misleading, resulting in a delay in diagnosis.
To evaluate the often puzzling plain film findings of late-presenting CDH in an effort to determine whether any of the findings could be helpful in arriving at an early diagnosis.
We reviewed and documented the plain film findings and clinical data in eight patients seen during the last 20 years with late-presenting CDH. IRB exempt status was obtained in this study.
There were five boys and three girls. The age range was 4 months to 12 years with a mean of 2.4 years. Five children presented with acute respiratory problems while three presented with acute abdominal pain. Two children presented with both respiratory and abdominal findings and one also presented with hematemesis. Two children had radiographic findings that were not difficult to analyze while the remaining six had findings that posed initial diagnostic problems.
Although not common, late-presenting CDH can result in confusing plain film radiographic findings and a delay in diagnosis. We found that the most important finding in analyzing these radiographs is in evaluating the location and position of the gastric bubble with the more common left-side hernias.
先天性膈疝延迟出现时的影像学表现可能具有迷惑性和误导性，导致诊断延误。
评估迟发性 CDH 平片表现的常见问题，以确定是否有任何表现有助于早期诊断。
我们回顾并记录了过去 20 年间在我院就诊的 8 例迟发性 CDH 患者的平片表现和临床资料。本研究获得了机构审查委员会的豁免。
8 例患儿中，男 5 例，女 3 例；年龄 4 个月至 12 岁，平均 2.4 岁。5 例患儿以急性呼吸问题就诊，3 例以急性腹痛就诊，2 例患儿同时出现呼吸和腹部表现，1 例还出现呕血。2 例患儿的 X 线片表现易于分析，而其余 6 例患儿的 X 线片表现则存在初步诊断问题。
尽管不常见，但迟发性 CDH 可导致混淆的平片 X 线表现和诊断延误。我们发现，分析这些 X 线片时最重要的发现是评估胃泡的位置和位置，对于更常见的左侧疝。
