title: Congenital diaphragmatic hernia: delayed presentation with asymptomatic spleenic herniation.
abstract: Patients with congenital diaphragmatic hernia (CDH) usually present in the immediate neonatal period with respiratory distress. Presentation beyond the neonatal period has, however, been reported. We report a case of a 3-year-old child who presented with a six months history of respiratory symptoms and had been subjected to a variety of therapies like antibiotics, antitubercular medication and two attempts at putting an intercostal tube, as radiographs were suggestive of pleural effusion. This study highlights the importance of a high index of suspicion, relevance of thorough clinical examination and non-invasive diagnostic modalities along with an uncommon occurrence of asymptomatic spleenic herniation at such a later age. Spleenic herniation is rare outside neonatal period.
authors.affiliation: Department of Pediatrics and Pediatric Surgery, Kalawati Saran Children's Hospital and Lady Hardinge Medical College, New Delhi, India.
authors.forename: Arvind
authors.initials: A
authors.lastname: Sehgal
authors.forename: Jagdish
authors.initials: J
authors.lastname: Chandra
authors.forename: Varinder
authors.initials: V
authors.lastname: Singh
authors.forename: A K
authors.initials: AK
authors.lastname: Dutta
authors.forename: Deepak
authors.initials: D
authors.lastname: Bagga
mesh_terms: D002675:Child, Preschool; D005260:Female; D006547:Hernia / Q000175:diagnosis / Q000209:etiology; D006548:Hernia, Diaphragmatic / Q000150:complications* / Q000175:diagnosis; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D013158:Splenic Diseases / Q000175:diagnosis / Q000209:etiology*; D013997:Time Factors