Planting N S, Hoffman-Haringsma A K E
Sint Franciscus Gasthuis, afd. Kindergeneeskunde, Rotterdam.
Ned Tijdschr Geneeskd. 2017;161:D960.
Congenital diaphragmatic hernia (CDH) is a rare congenital defect. Most cases are currently diagnosed either prenatally by ultrasound or shortly after birth. Late presentation of CDH is uncommon, and symptoms vary greatly. Here we describe two cases. The first concerns a 9-year-old boy with abdominal pain. The symptoms were interpreted as constipation and he was admitted for a high enema. After a few hours he developed severe respiratory distress; chest X-ray revealed a tension gastrothorax, and thoracostomy resulted in immediate respiratory improvement. In the second case, a 6-month-old girl presented with haematemesis and electrolyte imbalance. She was admitted for rehydration and correction of the electrolyte balance. A chest X-ray was performed because of persistent vomiting, and this showed an intrathoracal stomach. Late presentation of CDH is often misdiagnosed, with the risk of serious morbidity and mortality. Tension gastrothorax is a rare, life-threatening complication which should be treated by emergency gastric decompression..
先天性膈疝（CDH）是一种罕见的先天性缺陷。目前大多数病例在产前通过超声诊断，或在出生后不久确诊。CDH的延迟表现并不常见，症状差异很大。在此我们描述两例病例。第一例是一名9岁男孩，有腹痛症状。这些症状被解释为便秘，他因接受高位灌肠而入院。几小时后，他出现严重呼吸窘迫；胸部X线显示张力性胃胸，胸腔造口术后呼吸立即改善。第二例是一名6个月大的女孩，出现呕血和电解质失衡。她因补液和纠正电解质平衡而入院。因持续呕吐进行了胸部X线检查，结果显示胸腔内有胃。CDH的延迟表现常被误诊，存在严重发病和死亡风险。张力性胃胸是一种罕见的、危及生命的并发症，应通过紧急胃减压进行治疗。
