Open Access
Subscription Access
Open Access
Subscription Access
Fatal Outcome of Undetected Congenital Diaphragmatic Defect: Two Autopsy Cases
Subscribe/Renew Journal
Congenital diaphragmatic hernia is one of the most frequently occurring anomalies of the thorax and seen once in every 2 000 to 5 000 births. Herniation of the abdominal organs into thoracic cavity through the defect in the diaphragm takes place early in gestation resulting in varying degrees of pulmonary hypoplasia. The defect is usually in the posterolateral aspect of the diaphragm. The size and the location of the defect affect the degree of pulmonary hypoplasia and clinical presentation. In 65 to 80 % of the cases the defect is in the right hemidiaphragm.
The mortality rate of congenital diaphragmatic hernia is high despite advances in neonatal intensive care and the overall mortality rate from multiple studies is approximately 50 %.
We report a 4-year-old girl and a newborn boy died of complications resulting from congenital unilateral diaphragmatic defect. On forensic autopsy, parts of the abdominal organs were found to be in the left chest cavity and there was a defect on the left leaflet of the diaphragm in both cases. The deaths of the child and newborn were attributed to the complications of the congenital diaphragmatic defect.
These cases emphasize the importance of complete evaluation of fetuses before and after birth and follow-up of all "healthy" children.
Keywords
- Smith NP, Jesudason EC, Losty PD. Congenital diaphragmatic hernia. Pediatric Respiratory Reviews 2002, 3:339-348
- Rescorla FJ, Yader MC, West KW, et al. Delayed presentation of a right-sided diaphragmatic hernia and group B streptococcal sepsis, two case reports and review of the literature. Arch Surg 1989, 124: 1083-1086.
- Beglaj M, Spicer R, Ashworth M. Unilateral agenesis of the diaphragm: a separate entity or an extremely large defect? Pediatr Surg Int 1999, 15: 206-209.
- Singh SJ, Cummins GE, Cohen RC,et al. Adverse outcome of congenital diaphragmatic hernia is determined by diaphragmatic agenesis, not by antenatal diagnosis. J Pediatr Surg 1999, 34:1740-42.
- Butler N, Claireaux AE. Congenital diaphragmatic hernia as a cause of perinatal mortality. Lancet 1962, 1:659-663.
- Bajaj P, Tayal A, Logani KB, Bhan S. Congenital diaphragmatic hernia: a retrospective autopsy study. Indian Pediatr 1991, 28: 495-500.
- Smith NP, Edwin CJ, Losty PD. Congenital diaphtagmatic hernia. Paediatric respiratory Reviews 2002, 3:339-348.
Abstract Views: 170
PDF Views: 0