KP Tsui, KW Chan, KH Lee

Abstract

Congenital diaphragmatic hernia can present beyond the neonatal period. This article reports 2 cases of late-presenting congenital diaphragmatic hernia (CDH) in children presenting with symptoms of acute abdominal pain and respiratory distress. The diagnosis was confirmed on chest X-ray which showed herniation of abdominal organs into the left hemithorax and mediastinal shift to the right. In one child, the diagnosis was further confirmed with limited contrast follow through. The hernia defects were repaired through laparotomy and laparoscopy respectively. Late-presenting CDH poses diagnostic difficulties and children presenting with non specific respiratory or abdominal symptoms may actually suffer from acute complications of CDH.

先天性膈疝亦能出現在非嬰兒期，這2例遲發性兒童先天性膈疝的病人有腹痛和呼吸窘迫的症狀。X線顯示腹部器官形成的疝進入左側胸廓內，且出現縱隔的右移，並據此診斷此病。其中一個病人，其後應用局限性造影進一步診斷。膈疝可分別應用剖腹手術或腹腔鏡進行修補。由於遲發性兒童先天性膈疝的患兒通常沒有可以提示其急性併發症的特異性呼吸及腹部症狀，故診斷較困難。