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一例罕见的小儿III型先天性食管旁裂孔疝合并婴儿肥厚性幽门狭窄病例报告。

A rare pediatric case of type III congenital paraesophageal hiatal hernia with infantile hypertrophic pyloric stenosis: A case report.

作者信息

Yama Mujtaba, Shafiqi Muhammad, Rahimi Ali, Shayan Nasar Ahmad

机构信息

Afghan Arya Hospital, Herat, Afghanistan.

Department of Curative Medicine, Faculty of Medicine, Jami University, Herat, Afghanistan; Department of Pediatrics, Faculty of Medicine, Herat University, Herat, Afghanistan.

出版信息

Int J Surg Case Rep. 2025 Feb;127:110850. doi: 10.1016/j.ijscr.2025.110850. Epub 2025 Jan 6.

Abstract

INTRODUCTION

This case report presents a rare occurrence of Type III Congenital Paraesophageal Hiatal Hernia (CPEHH) with Infantile Hypertrophic Pyloric Stenosis (IHPS) in a 28-day-old neonate. However, this unusual combination poses significant diagnostic and surgical challenges.

PRESENTATION OF CASE

A 28-day-old male presented with respiratory distress and persistent vomiting. Imaging revealed CPEHH in the stomach and gastroesophageal junction in the thoracic cavity. IHPS was also identified during surgery. The patient underwent successful reduction of the hernia, pyloromyotomy, or Dor fundoplication with an uneventful recovery.

DISCUSSION

The combination of CPEHH and IHPS is extremely rare, leading to diagnostic delays and increased risk of complications. Early surgical intervention is crucial in preventing severe outcomes such as gastric volvulus.

CONCLUSION

This case underscores the importance of early diagnosis and coordinated surgical management in complex neonatal conditions, such as concurrent CPEHH and IHPS, contributing to the limited literature on this rare combination.

摘要

引言

本病例报告展示了一名28日龄新生儿罕见地同时患有III型先天性食管旁裂孔疝(CPEHH)和婴儿肥厚性幽门狭窄(IHPS)。然而,这种不寻常的组合带来了重大的诊断和手术挑战。

病例介绍

一名28日龄男性患儿出现呼吸窘迫和持续性呕吐。影像学检查显示胸腔内胃和胃食管交界处存在CPEHH。手术中还发现了IHPS。患者成功进行了疝修补、幽门肌切开术或Dor胃底折叠术,术后恢复顺利。

讨论

CPEHH和IHPS的组合极为罕见,导致诊断延迟并增加了并发症风险。早期手术干预对于预防诸如胃扭转等严重后果至关重要。

结论

本病例强调了在复杂的新生儿疾病(如同时存在CPEHH和IHPS)中早期诊断和协调手术管理的重要性,为关于这种罕见组合的有限文献增添了内容。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c967/11864158/a225a82d3f5a/gr1.jpg

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