Death due to late-presenting congenital diaphragmatic hernia in a 2-year-old child.
Congenital diaphragmatic hernia (CDH) is classically regarded as a neonatal defect presenting with respiratory distress; however, not all CDH will present in this manner. Unlike newborn deaths related to CDH, where the mechanism of death is respiratory in nature, the mechanism of death in late-presenting CDH is not always due to respiratory compromise. In this case report, we present a death occurring in a 2 1/2-year-old child who presented to the emergency department with complaints of abdominal pain and emesis, and then rapidly decompensated and died. Autopsy revealed a CDH, with herniation of abdominal contents into the left thoracic cavity, with associated gastric volvulus, necrosis, and rupture.
Vandy
Frank C
FC
Indiana University School of Medicine, Indianapolis, IN, USA.
Landrum
Jeffry E
JE
Gerig
Nita R
NR
Prahlow
Joseph A
JA
D015746:Abdominal Pain / Q000209:etiology; D002675:Child, Preschool; D003106:Colon / Q000098:blood supply / Q000473:pathology; D004386:Duodenum / Q000098:blood supply / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D049429:Forensic Pathology; D006323:Heart Arrest / Q000209:etiology; D006548:Hernia, Diaphragmatic / Q000473:pathology*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007238:Infarction / Q000473:pathology; D007511:Ischemia / Q000473:pathology; D008168:Lung / Q000473:pathology; D009336:Necrosis; D010179:Pancreas / Q000098:blood supply / Q000473:pathology; D001261:Pulmonary Atelectasis / Q000473:pathology; D013270:Stomach / Q000098:blood supply / Q000473:pathology; D013275:Stomach Rupture / Q000209:etiology / Q000473:pathology; D013277:Stomach Volvulus / Q000473:pathology; D014839:Vomiting / Q000209:etiology