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在新冠疫情背景下的成人迟发性膈疝致死病例

Fatal adult-onset diaphragmatic hernia in the context of the COVID-19 pandemic.

作者信息

Antony Ajith, Suares Sheryl, Fernandes André Victor

机构信息

Goa Medical College, Department of Forensic Medicine and Toxicology, Bambolim, Goa, India.

出版信息

Autops Case Rep. 2022 Jan 14;12:e2021366. doi: 10.4322/acr.2021.366. eCollection 2022.

Abstract

Late-presenting or "Adult-Onset" Diaphragmatic Hernia is uncommon, especially in individuals with no history of trauma. The non-traumatic diaphragmatic hernia may be a Congenital Diaphragmatic Hernia [CDH] lately manifested as a sequela to an iatrogenic intervention or prolonged infections. We aim to explore the genetic correlations in "adult-onset" CDH, with an insight into the indirect contribution of the COVID-19 pandemic towards the fatal outcome.In this report, we present a case of an adult female who died from the complications of an undiagnosed adult-onset diaphragmatic hernia, deemed completely preventable, if not for the global COVID-19 pandemic. There was no prior history of physical trauma or medical history of any relevance.Early diagnosis and rapid surgical intervention remain the keystone management for successfully treating individuals affected by this entity. The decedent in question presented with symptoms demanding hospital stay for investigations that would have aided in timely diagnosis and prevented death. However, the excessive fear of COVID-19 prevented the patient from undergoing hospitalization and follow-up, delaying the diagnosis and leading to death.

摘要

迟发性或“成人起病型”膈疝并不常见,尤其是在没有外伤史的个体中。非创伤性膈疝可能是先天性膈疝(CDH),最近表现为医源性干预或长期感染的后遗症。我们旨在探索“成人起病型”CDH的遗传相关性,深入了解新冠疫情对致命结局的间接影响。在本报告中,我们介绍了一例成年女性病例,该患者死于未确诊的成人起病型膈疝并发症,如果不是因为全球新冠疫情,这一死亡被认为是完全可以预防的。患者此前没有身体创伤史或任何相关病史。早期诊断和快速手术干预仍然是成功治疗受该疾病影响个体的关键管理措施。该死者出现的症状需要住院进行有助于及时诊断并预防死亡的检查。然而,对新冠病毒的过度恐惧使患者无法住院和接受后续治疗,延误了诊断并导致死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbcc/8958449/018d9b1c6036/autopsy-12-e2021366-g01.jpg

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