Congenital diaphragmatic hernia with fetal hydrops causing postoperative intestinal perforation: An unusual manifestation seen in a neonate

Bibliographic Details
Title: Congenital diaphragmatic hernia with fetal hydrops causing postoperative intestinal perforation: An unusual manifestation seen in a neonate
Authors: Noboru Oyachi, Fuminori Numano, Tamami Fukatsu, Atsushi Nemoto, Atsushi Naito
Source: Journal of Pediatric Surgery Case Reports, Vol 84, Iss , Pp 102387- (2022)
Publisher Information: Elsevier, 2022.
Publication Year: 2022
Collection: LCC:Pediatrics
LCC:Surgery
Subject Terms: Congenital diaphragmatic hernia, Fetal hydrops, Intestinal perforation, Pediatrics, RJ1-570, Surgery, RD1-811
More Details: Congenital diaphragmatic hernia (CDH) is a common cause of neonatal mortality. If CDH is associated with non-immune fetal hydrops (FH), the mortality rate is even higher. However, the pathogenesis and management of FH associated with CDH are still under discussion. We present here a case of left-sided CDH accompanied by prolonged FH, where unexpected ileal perforation developed after CDH repair.The female patient was diagnosed with left-sided CDH with right-sided pleural effusion (PE) at 26 weeks' gestation. At 35 weeks' gestation, FH progressed with bilateral PE and the patient was delivered by cesarean section with a body weight of 2068 g and Apgar 3/7. Subcutaneous edema progressed, but PE attenuated with improvement of pulmonary hypertension, and CDH repair was performed on Day 4. Postoperatively, the patient's pulmonary hypertension worsened, and intestinal perforation was observed on Day 11. In the emergency laparotomy, there was a single small bowel perforation of 5 mm in diameter in the terminal ileum. A 5 cm of the ileum was resected and the bowel was anastomosed in a single stage. The patient was weaned from the ventilator on Day 28. Although bilateral periventricular leukomalacia was confirmed, the patient was discharged without significant neurological symptoms on Day 76.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2213-5766
Relation: http://www.sciencedirect.com/science/article/pii/S2213576622002147; https://doaj.org/toc/2213-5766
DOI: 10.1016/j.epsc.2022.102387
Access URL: https://doaj.org/article/85f158cc3b524beea973c08c3f5adae1
Accession Number: edsdoj.85f158cc3b524beea973c08c3f5adae1
Database: Directory of Open Access Journals
More Details
ISSN:22135766
DOI:10.1016/j.epsc.2022.102387
Published in:Journal of Pediatric Surgery Case Reports
Language:English