Kasdallah Nadia, Ben Salem Hatem, Kbaier Hakima, Blibech Sonia, Douagi Mohamed
Tunis Med. 2017 Feb;95(2):136-138.
Congenital diaphragm eventration is a rare and usually asymptomatic developmental defect. Neonatal gastric perforation is also a rare but lifethreatening condition. In our knowledge, the association of these two pathologies has been, exceptionally reported. We report a case who illustrates clinical and radiological features of this possible co-morbidity. A full-term male neonate was born from uneventful pregnancy and delivery. The antenatal scan was reported as normal. At birth, clinical exam was normal, no special resuscitation was necessary. The newborn was examined and admitted the 4th day of life for fever, tachypnea, cyanosis, hemodynamic shock and refusing feeds. Clinical examination suggested peritonitis. Chest radiography and ultrasonography suggested congenital hernia. A laparotomy was performed after a brief resuscitation and confirmed the presence of diaphragm eventration with gastric perforation. Suturing of gastric perforation with a diaphragmatic plication was performed with favorable evolution.
先天性膈膨升是一种罕见且通常无症状的发育缺陷。新生儿胃穿孔也是一种罕见但危及生命的病症。据我们所知,这两种病症的关联仅有极少的报道。我们报告一例病例,该病例展现了这种可能的合并症的临床和放射学特征。一名足月儿男婴出生时妊娠和分娩过程均正常。产前超声检查报告正常。出生时,临床检查正常,无需特殊复苏措施。该新生儿在出生后第4天因发热、呼吸急促、发绀、血流动力学休克及拒食而接受检查并入院。临床检查提示腹膜炎。胸部X线和超声检查提示先天性疝。经短暂复苏后进行了剖腹手术,证实存在膈膨升合并胃穿孔。对胃穿孔进行缝合并折叠膈肌,病情进展良好。