title: Successful complex management of a congenital diaphragmatic hernia--a case report.
abstract: Congenital diaphragmatic hernia is a very serious congenital defect associated with high mortality rate. The syndrome is characterized by migration of abdominal viscera to thoracic cavity a variable degree of pulmonary hypoplasia associated with pulmonary hypertension caused by alteration of pulmonary vessels diameter increased muscularisation of pulmonary arteries and decreased compliance of the lungs resulting in increased afterload of the right ventricle, decreased cardiac output and impaired oxygenation. We describe a case of congenital diaphragmatic hernia with migration of the stomach, the small and the large bowels and the left hepatic lobe into the left pleural space, diagnosed by ultrasound in utero at 24 weeks of gestation. The child was initially placed on high-frequency oscillation and nitric oxide and required vigorous inotropic support. The defect was repaired after stabilization of the cardiac output and gas exchange. The patient made successful recovery.
authors.affiliation: Neonatology Ward, 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland. bnajman@wp.pl
authors.forename: Bozena
authors.initials: B
authors.lastname: Kociszewska-Najman
authors.forename: Marcin
authors.initials: M
authors.lastname: Rawicz
authors.forename: Bronisława
authors.initials: B
authors.lastname: Pietrzak
authors.forename: Iwona
authors.initials: I
authors.lastname: Szymusik
authors.forename: Sadeq
authors.initials: S
authors.lastname: Yaseen
authors.forename: Bernadetta
authors.initials: B
authors.lastname: Olszyńska-Bazała
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Biejat
authors.forename: Piotr
authors.initials: P
authors.lastname: Wegrzyn
authors.forename: Mirosław
authors.initials: M
authors.lastname: Wielgoś
mesh_terms: D021721:Balloon Occlusion / Q000379:methods; D005260:Female; D005332:Fetoscopy / Q000379:methods; D006548:Hernia, Diaphragmatic / Q000000981:diagnostic imaging / Q000628:therapy; D065630:Hernias, Diaphragmatic, Congenital; D006612:High-Frequency Ventilation / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal