Late Presentation of Congenital Diaphragmatic Hernia: Report of Three Cases

Introduction

Congenital diaphragmatic hernia (CDH) still represents one of the most frustrating problems in the pediatric surgery. Medline database during the past 30 years has been registered almost 3,500 publications. Treatment difficulties and especially high hidden mortality for this anomaly before era of sophisticated imaging have inspired clinicians and scientists for maximal concentration, which brought better understanding of the pathophysiology and embriology.[1] Medical and technical efforts came to develop animal models of CDH and involvement of extracorporal membrane oxygenation (ECMO) and fetal surgery to the treatment protocols.[2] [3] [4] [5]

Diaphragmatic hernias may be classified by the location of the defect or by etiology. Most clinicians under the term CDH usually understand anomaly which presents just after birth with severe dyspnea and circulatory disturbances. Late presentation of CDH is uncommon.[6] [7] [8] [9] [10] [11] [12] For selected group of patients is still open the question, whether previously undiagnosed hernia is presenting since birth (latent, without any symptoms) or appears later on time of clinical manifestation. We present exceptional rare group of three patients who were previously treated in our hospital because of heart defect and at this time, they did not present clinical and radiological signs of CDH.

• References

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