Mahmood Mehreen, Meckmongkol Teerin, Westmoreland Tamarah
Emergency Medicine, University of Central Florida College of Medicine, Orlando, USA.
Pediatric Surgery, Nemours Children's Hospital, Orlando, USA.
Cureus. 2020 Sep 9;12(9):e10335. doi: 10.7759/cureus.10335.
We report the case of a 14-month-old female who had a right-sided congenital diaphragmatic hernia (CDH) without pulmonary hypoplasia. The patient was preoperatively diagnosed with a Morgagni hernia due to the size and location of the hernia seen on imaging. However, the patient was found to have bilateral diaphragmatic defects intraoperatively, and her right diaphragm was almost completely absent. Our patient did not have pulmonary hypoplasia or any of the respiratory comorbidities that CDH patients typically present with, though she did have repeated respiratory infections and cough. This case demonstrates that CDH is not always diagnosed in an accurate or timely manner radiographically and that the surgeon should be prepared to potentially repair more of the diaphragm than expected. Additionally, there is a need to study the pathophysiology and genetics of CDHs further.
我们报告了一例14个月大的女性患者，她患有右侧先天性膈疝（CDH）且无肺发育不全。根据影像学上所见疝的大小和位置，该患者术前被诊断为 Morgagni 疝。然而，术中发现患者双侧膈肌存在缺损，其右侧膈肌几乎完全缺失。我们的患者没有肺发育不全或CDH患者通常出现的任何呼吸合并症，尽管她确实有反复的呼吸道感染和咳嗽。该病例表明，CDH在影像学上并不总是能准确或及时地被诊断出来，并且外科医生应做好准备，可能需要修复比预期更多的膈肌。此外，有必要进一步研究CDH的病理生理学和遗传学。
