title: Coexistence of congenital diaphragmatic hernia and abdominal wall closure defect with chromosomal abnormality: two case reports.
abstract: BACKGROUND
  We reported two rare cases of congenital diaphragmatic hernia with abdominal wall closure defect, which were not associated with septum transversum diaphragmatic defects or Fryns syndrome.
  
  
  METHODS
  Case 1: a Japanese baby boy was delivered at 37 weeks' gestation by urgent cesarean section because of the diagnosis of severe fetal distress. Congenital diaphragmatic hernia with omphalocele was prenatally diagnosed with fetal ultrasound. A ruptured omphalocele was confirmed at delivery. A silo was established on the day of his birth; direct closure of his diaphragmatic defect and abdominal wall closure was performed on the fifth day after his birth. Trisomy 13 was confirmed by genetic examination. His postoperative course was uneventful and he was discharged 5 months postnatally with home oxygen therapy. He was readmitted because of heart failure and died at 6 months. Case 2: a Japanese baby boy, who was prenatally diagnosed with gastroschisis, was delivered at 35 weeks' gestation by urgent cesarean section because of the diagnosis of fetal distress. Silo construction using a wound retractor was performed on the day of his birth and direct abdominal closure was performed on the tenth day after his birth. Trisomy 21 was confirmed by genetic examination. Treatment for his respiratory distress was continued after surgery. A retrosternal hernia was revealed at 6 months and direct closure of retrosternal diaphragm with the resection of hernia sac was performed. His postoperative course was uneventful and he was discharged with home oxygen therapy.
  
  
  CONCLUSIONS
  Attention should be paid to chromosomal abnormality in cases in which the coexistence of congenital diaphragmatic hernia and abdominal wall closure defect are observed.
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kamoda 1981, Kawagoe, Saitama, 3508550, Japan. sei_khsr@saitama-med.ac.jp.
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Inoue
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kamoda 1981, Kawagoe, Saitama, 3508550, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Odaka
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kamoda 1981, Kawagoe, Saitama, 3508550, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Muta
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kamoda 1981, Kawagoe, Saitama, 3508550, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Beck
authors.affiliation: Department of Neonatology, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kamoda 1981, Kawagoe, Saitama, 3508550, Japan.
authors.forename: Hisanori
authors.initials: H
authors.lastname: Sobajima
authors.affiliation: Department of Neonatology, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kamoda 1981, Kawagoe, Saitama, 3508550, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Tamura
mesh_terms: D034861:Abdominal Wall / Q000002:abnormalities*; D002869:Chromosome Aberrations; D004314:Down Syndrome / Q000175:diagnosis*; D017809:Fatal Outcome; D006330:Heart Defects, Congenital / Q000150:complications* / Q000473:pathology / Q000628:therapy; D006333:Heart Failure / Q000209:etiology; D006554:Hernia, Umbilical / Q000150:complications / Q000000981:diagnostic imaging*; D065630:Hernias, Diaphragmatic, Congenital / Q000150:complications* / Q000473:pathology / Q000628:therapy; D006801:Humans; D007231:Infant, Newborn; D007621:Karyotyping; D008297:Male; D016216:Ultrasonography, Prenatal