Delayed Presentation of Congenital Diaphragma Hernia

Congenital diaphragma hernia occurs as a result of defect in the closure of pleuroperitoneal pleat on the 9th gestation week. It is usually presented with respiratory distress after birth. Rarely presentation is delayed. Diagnosis is performed with chest roentgenogram in asymptomatic individuasis. Mild or severe symptoms, such as respiratuar distress and obstruction of gastrointestinal tract may be observed.

Inguinal herni operation was planned for a 7 year old girl and her chest roentgenogram was pathologic preope-ratively and the patient was hospitalized. In history intermittan emesis complaint was told for 1 year and also she recovered from pneumonia 1 year ago. In her physical examination her height and weight are below 3SD. There was no respiratuar distress and fever and, no pathological signs except decrease of respiratuar
sounds with auscultation on the left part of chest. Laboratory findings: WBC 6700/mm3 Hb 12 g/dL, Hct 37 %, PLT 222.000/mm3, CRP (-), ESR 30 mm/hour, PPD (-), ARB (-),
biochemical findings were normal. The imaginations like diaphragma hemi were seen on thorax CT which were planned when there was no correlation between radiological
and clinical findings. With contrast material the diagnosis was proved. The patient’s diagnosis is Bochdalek herni and with surgical therapy, she is recovered without complication.

Congenital diaphragma hernia is the most frequent intrathoracic fetal anomaly, but delayed presentation of congenital diaphragma hernia is rare. This disorder must be in diferantial diagnosis with pneumonia and pleural effusion because of it this case is reported.

Geç Bulgu Veren Konjenital Diyafragma Hernisi