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右侧先天性膈疝合并肠旋转不良:一例罕见病例报告。

Right-Sided Congenital Diaphragmatic Hernia With Gut Malrotation: A Rare Case Report.

作者信息

Thorbole Neha, Malwade Sudhir, Denge Abhishek, Kale Shivani

机构信息

Department of Paediatrics, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.

出版信息

Cureus. 2024 Jul 28;16(7):e65602. doi: 10.7759/cureus.65602. eCollection 2024 Jul.

Abstract

Congenital diaphragmatic hernia (CDH) is a rare surgical cause of respiratory distress in neonates. CDH is caused by the protrusion of the abdominal contents into the thoracic cavity due to the failure of the pleuroperitoneal canal to close by eight weeks of gestation. We present the case of a full-term, female child, weighing 2.85 kg at birth, born by normal vaginal delivery to a 21-year-old primigravida admitted at our level III neonatal intensive care unit (NICU). Antenatal obstetric ultrasonography suggested duodenal atresia. After birth, the child was found to have right-sided CDH with gut malrotation. Intraoperative laparotomy revealed a right Bochdalek posterolateral defect with herniation of small bowel loops and a portion of the right lobe of the liver into the chest cavity and minimally malrotated cecum in the right iliac fossa (RIF). This case highlights the critical need for early detection and multidisciplinary management of congenital anomalies. Effective management requires a multidisciplinary approach, including prenatal counseling, careful surgical intervention, and intensive neonatal care to optimize respiratory and cardiovascular outcomes for affected infants.

摘要

先天性膈疝(CDH)是新生儿呼吸窘迫的一种罕见外科病因。CDH是由于在妊娠8周时胸膜腹膜管未能闭合,导致腹腔内容物突入胸腔所致。我们报告一例足月女婴病例,出生体重2.85千克,经正常阴道分娩,其母亲为一名21岁初产妇,该患儿入住我们的三级新生儿重症监护病房(NICU)。产前产科超声检查提示十二指肠闭锁。出生后,发现该患儿患有右侧CDH并伴有肠旋转不良。术中剖腹探查发现右侧Bochdalek后外侧缺损,小肠袢和部分肝右叶疝入胸腔,右髂窝(RIF)处盲肠轻度旋转不良。该病例凸显了早期发现和多学科管理先天性异常的迫切需求。有效的管理需要多学科方法,包括产前咨询、仔细的手术干预以及强化新生儿护理,以优化受影响婴儿的呼吸和心血管结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1b4/11349924/4729e3b8e84a/cureus-0016-00000065602-i01.jpg

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