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Published in: Pediatric Radiology 3/2012

01-03-2012 | Original Article

Radiographic findings in late-presenting congenital diaphragmatic hernia: helpful imaging findings

Authors: Sofia Muzzafar, Leonard E. Swischuk, Siddharth P. Jadhav

Published in: Pediatric Radiology | Issue 3/2012

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Abstract

Background

Imaging findings in delayed presentation of congenital diaphragmatic hernia can be confusing and misleading, resulting in a delay in diagnosis.

Objective

To evaluate the often puzzling plain film findings of late-presenting CDH in an effort to determine whether any of the findings could be helpful in arriving at an early diagnosis.

Material and methods

We reviewed and documented the plain film findings and clinical data in eight patients seen during the last 20 years with late-presenting CDH. IRB exempt status was obtained in this study.

Results

There were five boys and three girls. The age range was 4 months to 12 years with a mean of 2.4 years. Five children presented with acute respiratory problems while three presented with acute abdominal pain. Two children presented with both respiratory and abdominal findings and one also presented with hematemesis. Two children had radiographic findings that were not difficult to analyze while the remaining six had findings that posed initial diagnostic problems.

Conclusion

Although not common, late-presenting CDH can result in confusing plain film radiographic findings and a delay in diagnosis. We found that the most important finding in analyzing these radiographs is in evaluating the location and position of the gastric bubble with the more common left-side hernias.
Literature
1.
go back to reference Baglaj M, Dorobisz U (2005) Late-presenting congenital diaphragmatic hernia in children: a literature review. Pediatr Radiol 35:478–488PubMedCrossRef Baglaj M, Dorobisz U (2005) Late-presenting congenital diaphragmatic hernia in children: a literature review. Pediatr Radiol 35:478–488PubMedCrossRef
2.
go back to reference Berman L, Stringer D, Ein SH et al (1988) The late presenting pediatric Bochdalek hernia: a 20-year review. J Pediatr Surg 23:735–739PubMedCrossRef Berman L, Stringer D, Ein SH et al (1988) The late presenting pediatric Bochdalek hernia: a 20-year review. J Pediatr Surg 23:735–739PubMedCrossRef
3.
go back to reference Chang SW, Lee HC, Yeung CY et al (2010) A 20-year review of early and late-presenting congenital Bochdalek diaphragmatic hernia: are they different clinical spectra? Pediatr Neonatol 51:26–30PubMedCrossRef Chang SW, Lee HC, Yeung CY et al (2010) A 20-year review of early and late-presenting congenital Bochdalek diaphragmatic hernia: are they different clinical spectra? Pediatr Neonatol 51:26–30PubMedCrossRef
4.
go back to reference Malone PS, Brain AJ, Kiely EM et al (1989) Congenital diaphragmatic defects that present late. Arch Dis Child 64:1542–1544PubMedCrossRef Malone PS, Brain AJ, Kiely EM et al (1989) Congenital diaphragmatic defects that present late. Arch Dis Child 64:1542–1544PubMedCrossRef
5.
go back to reference Sridhar AV, Nichani S (2004) Late presenting congenital diaphragmatic hernia. Emerg Med J 21:261–262PubMedCrossRef Sridhar AV, Nichani S (2004) Late presenting congenital diaphragmatic hernia. Emerg Med J 21:261–262PubMedCrossRef
6.
go back to reference Cigdem MK, Onen A, Otcu S et al (2007) Late presentation of bochdalek-type congenital diaphragmatic hernia in children: a 23-year experience at a single center. Surg Today 37:642–645PubMedCrossRef Cigdem MK, Onen A, Otcu S et al (2007) Late presentation of bochdalek-type congenital diaphragmatic hernia in children: a 23-year experience at a single center. Surg Today 37:642–645PubMedCrossRef
7.
go back to reference Gaisie G, Young LW, Oh KS (1983) Late-onset Bochdalek’s hernia with obstruction: radiographic spectrum of presentation. Clin Radiol 34:267–270PubMedCrossRef Gaisie G, Young LW, Oh KS (1983) Late-onset Bochdalek’s hernia with obstruction: radiographic spectrum of presentation. Clin Radiol 34:267–270PubMedCrossRef
8.
go back to reference Quah BS, Hashim I, Simpson H (1999) Bochdalek diaphragmatic hernia presenting with acute gastric dilation. J Pediatr Surg 34:512–514PubMedCrossRef Quah BS, Hashim I, Simpson H (1999) Bochdalek diaphragmatic hernia presenting with acute gastric dilation. J Pediatr Surg 34:512–514PubMedCrossRef
9.
go back to reference Byard RW, Bourne AJ, Cockington RA (1991) Fatal gastric perforation in a 4-year-old child with a late presenting congenital diaphragmatic hernia. Pediatr Surg Int 6:44–46CrossRef Byard RW, Bourne AJ, Cockington RA (1991) Fatal gastric perforation in a 4-year-old child with a late presenting congenital diaphragmatic hernia. Pediatr Surg Int 6:44–46CrossRef
11.
go back to reference Glasson MJ, Barter W, Cohen DH et al (1975) Congenital left posterolateral diaphragmatic hernia with previously normal chest x-ray. Pediatr Radiol 3:204–205CrossRef Glasson MJ, Barter W, Cohen DH et al (1975) Congenital left posterolateral diaphragmatic hernia with previously normal chest x-ray. Pediatr Radiol 3:204–205CrossRef
12.
go back to reference Gayer G, Bilik R, Vardi A et al (1999) CT diagnosis of delayed presentation of congenital diaphragmatic hernia simulating massive pleuropneumonia. Eur Radiol 9:1672–1674PubMedCrossRef Gayer G, Bilik R, Vardi A et al (1999) CT diagnosis of delayed presentation of congenital diaphragmatic hernia simulating massive pleuropneumonia. Eur Radiol 9:1672–1674PubMedCrossRef
Metadata
Title
Radiographic findings in late-presenting congenital diaphragmatic hernia: helpful imaging findings
Authors
Sofia Muzzafar
Leonard E. Swischuk
Siddharth P. Jadhav
Publication date
01-03-2012
Publisher
Springer-Verlag
Published in
Pediatric Radiology / Issue 3/2012
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-011-2226-9

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