title: Acute gastro-intestinal obstruction as a late presentation of congenital diaphragmatic hernia. A report of three cases.
abstract: Three cases of acute gastro-intestinal obstruction due to incarceration of congenital diaphragmatic hernia (Bochdalek hernia) in infants are reported. The level of incarceration was stomach, small and large intestine. All of the presented posterolateral diaphragmatic defects were small and without a sac. History of trauma was absent in all patients. Two girls recovered well while a boy died of intracerebral bleeding one month after surgery. Acute gastro-intestinal obstruction as a late, post neonatal, presentation of congenital diaphragmatic hernia is a rare, life-threatening emergency. The combination of gastro-intestinal obstruction, circulatory and respiratory distress requires urgent gastro-intestinal decompression, fluid resuscitation and ventilatory support. Surgery can be performed safely only after pre-operative stabilization.
authors.affiliation: Department of Pediatric Surgery, Charles University in Prague, 2nd Faculty of Medicine and Teaching Hospital in Motol, Czech Republic. mrygl@yahoo.com
authors.forename: M
authors.initials: M
authors.lastname: Rygl
authors.forename: R
authors.initials: R
authors.lastname: Skába
authors.forename: J
authors.initials: J
authors.lastname: Lisý
authors.forename: K
authors.initials: K
authors.lastname: Pýcha
mesh_terms: D002543:Cerebral Hemorrhage / Q000209:etiology; D002675:Child, Preschool; D003108:Colonic Diseases / Q000209:etiology / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D017219:Gastric Outlet Obstruction / Q000209:etiology* / Q000601:surgery; D006548:Hernia, Diaphragmatic / Q000601:surgery; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007223:Infant; D007415:Intestinal Obstruction / Q000209:etiology* / Q000601:surgery; D007421:Intestine, Small / Q000473:pathology / Q000601:surgery; D007813:Laparotomy; D008297:Male; D011183:Postoperative Complications