Ménassa Michel, Bergeron Anne-Marie, Drolet Sébastien, Bouchard Alexandre
Department of Surgery, Centre Hospitalier Universitaire de Québec, Québec, QC.
Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire de Québec, Québec, QC.
J Obstet Gynaecol Can. 2019 Oct;41(10):1482-1484. doi: 10.1016/j.jogc.2018.12.024. Epub 2019 Feb 22.
Congenital diaphragmatic hernia is an unusual condition in the adult population because it is mostly a neonatal diagnosis. This entity may be triggered by pregnancy and threaten the life of the mother and her fetus.
This report presents the case of a maternal diaphragmatic hernia diagnosed at 35 weeks of pregnancy with epigastric pain, nausea, and vomiting. Patient developed respiratory distress, and a radiograph revealed left lung collapse. A chest tube was inserted for a presumed tension pneumothorax. The patient's condition deteriorated, and a diaphragmatic hernia containing the stomach, transverse colon, and small bowel was diagnosed. The patient underwent laparotomy with Caesarean section, hernia reduction, and diaphragmatic repair.
A high degree of suspicion is required to avoid misdiagnosis and management delay. Surgical treatment must be individualized according to gestational age and clinical setting.
先天性膈疝在成人中并不常见，因为它大多是在新生儿期被诊断出来的。这种情况可能由怀孕引发，并威胁母亲及其胎儿的生命。
本报告介绍了一名在怀孕35周时被诊断出患有母亲膈疝的病例，患者出现上腹部疼痛、恶心和呕吐。患者出现呼吸窘迫，X线片显示左肺萎陷。因疑似张力性气胸插入了胸管。患者病情恶化，诊断为含有胃、横结肠和小肠的膈疝。患者接受了剖腹术加剖宫产、疝还纳和膈肌修复术。
需要高度怀疑以避免误诊和治疗延误。手术治疗必须根据孕周和临床情况个体化。
