Congenital Diaphragmatic Hernia Presenting with Tension Pneumothorax in a 3-Year-Old Boy

We report the case of a 3-year-old boy who presented with an upper respiratory tract infection and severe dyspnea. A chest X-ray revealed a left-sided tension pneumothorax with mediastinal shift and suspected enterothorax. After thoracic computed tomography (CT) scan, a chest tube was inserted, whic...

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Bibliographic Details
Main Authors: Maren Friederike Balks, Jan-Hendrik Gosemann, Ina Sorge, Martin Lacher, Franz Wolfgang Hirsch
Format: Article
Language:English
Published: Georg Thieme Verlag KG 2018-01-01
Series:European Journal of Pediatric Surgery Reports
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1667357
Description
Summary:We report the case of a 3-year-old boy who presented with an upper respiratory tract infection and severe dyspnea. A chest X-ray revealed a left-sided tension pneumothorax with mediastinal shift and suspected enterothorax. After thoracic computed tomography (CT) scan, a chest tube was inserted, which drained fluid which had the same consistency and color as the one derived from the nasogastric (NG) tube. The boy underwent diagnostic laparoscopy for suspected bowel perforation, which confirmed a left-sided Bochdalek hernia with herniation of the viscera into the chest. After repositioning of the herniated organs into the abdomen, a gastric perforation was identified and repaired. This case demonstrates that the cause of a tension pneumothorax in an infant may be a rare combination of congenital diaphragmatic hernia (CDH) and perforation of a visceral hollow organ.
ISSN:2194-7619
2194-7627