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婴儿先天性膈膨升:诊断陷阱与成功的手术治疗

Congenital Diaphragmatic Eventration in an Infant: Diagnostic Pitfalls and Successful Surgical Management.

作者信息

Zouirech Yacine, Bouljrouf Jawad, Manni Abir, Ochan Monim, Kisra Mounir

机构信息

Pediatric Surgery Department "A" Children's Hospital, Ibn Sina University Hospital Center, Rabat, MAR.

Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, MAR.

出版信息

Cureus. 2025 Apr 10;17(4):e82017. doi: 10.7759/cureus.82017. eCollection 2025 Apr.

Abstract

Congenital diaphragmatic eventration (CDE) is a rare condition characterized by abnormal elevation of an intact but thinned diaphragm. Severe cases may mimic congenital diaphragmatic hernia (CDH), leading to respiratory distress in infants. We report the case of a nine-month-old male baby presenting with chronic chest retractions and feeding difficulties, who developed acute respiratory distress initially misdiagnosed as right-sided CDH with pneumonia. Frontal chest radiography suggested herniation, but lateral imaging and surgical findings confirmed right-sided CDE. The patient underwent diaphragmatic plication via a right thoracotomy. Postoperative management, including ventilatory support, led to complete resolution of symptoms and full recovery. This case highlights the importance of accurate imaging, correct diagnosis, and timely surgical intervention.

摘要

先天性膈膨升(CDE)是一种罕见病症,其特征为完整但变薄的膈肌异常抬高。严重病例可能类似先天性膈疝(CDH),导致婴儿出现呼吸窘迫。我们报告一例9个月大男婴的病例,该患儿有慢性胸部凹陷和喂养困难,最初出现急性呼吸窘迫,被误诊为右侧CDH合并肺炎。胸部正位X线片提示有疝形成,但侧位影像及手术结果证实为右侧CDE。该患者通过右胸切开术进行了膈肌折叠术。术后管理包括通气支持,症状完全缓解且实现了完全康复。本病例突出了准确成像、正确诊断及及时手术干预的重要性。

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