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Intestinal Perforation during the Stabilization Period in a Preterm Infant with Congenital Diaphragmatic Hernia

. 2017 Jan ; 5 (1) : e51-e54. [epub] 20170831

Status PubMed-not-MEDLINE Language English Country Germany Media print-electronic

Document type Case Reports, Journal Article

Background Delayed surgery after stabilization of infants with congenital diaphragmatic hernia (CDH) is an accepted strategy. However, the evidence favoring delayed versus immediate surgical repair is limited. We present an extremely rare case of a very low-birth-weight infant with prenatally diagnosed left-sided CDH and unexpected transmural bowel perforations developing within the postnatal stabilization period. Case Report A neonate born at 31st week of gestation with a birth weight of 1,470 g with antenatally diagnosed left-sided CDH presented with bowel dilation leading to transmural bowel perforations on the 2nd day of life. Meconium pleuroperitonitis resulted in severe systemic inflammatory response syndrome, pulmonary hypertension, multiple organ failure, and death. Conclusion In neonates with CDH deteriorating under standard postnatal management, intestinal perforation, and early surgical intervention should be considered.

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Grover T R, Murthy K, Brozanski B et al.Short-term outcomes and medical and surgical interventions in infants with congenital diaphragmatic hernia. Am J Perinatol. 2015;32(11):1038–1044. PubMed

Reiss I, Schaible T, van den Hout L et al.Standardized postnatal management of infants with congenital diaphragmatic hernia in Europe: the CDH EURO Consortium consensus. Neonatology. 2010;98(04):354–364. PubMed

Garriboli M, Duess J W, Ruttenstock E et al.Trends in the treatment and outcome of congenital diaphragmatic hernia over the last decade. Pediatr Surg Int. 2012;28(12):1177–1181. PubMed

Moyer V, Moya F, Tibboel R, Losty P, Nagaya M, Lally K P. Late versus early surgical correction for congenital diaphragmatic hernia in newborn infants. Cochrane Database Syst Rev. 2000;(03):CD001695. PubMed

Hollinger L E, Lally P A, Tsao K, Wray C J, Lally K P; Congenital Diaphragmatic Hernia Study Group.A risk-stratified analysis of delayed congenital diaphragmatic hernia repair: does timing of operation matter? Surgery 201415602475–482. PubMed

Silverman J F, Kopelman A E.Meconium pleuritis: cytologic diagnosis in a neonate with perforated sigmoid colon and diaphragmatic hernia Pediatr Pathol 19866(2-3):325–333. PubMed

Christopher T D, Effmann E L, Filston H C. Meconium peritonitis and pleuritis: a clue to perforation of an incarcerated Bochdalek hernia in a neonate. J Pediatr Surg. 1990;25(05):558–559. PubMed

Manning P B, Murphy J P, Raynor S C, Ashcraft K W. Congenital diaphragmatic hernia presenting due to gastrointestinal complications. J Pediatr Surg. 1992;27(09):1225–1228. PubMed

Butterworth S A, Webber E M. Meconium thorax: A case of Bochdalek hernia and cecal perforation in a neonate with Job's syndrome. J Pediatr Surg. 2002;37(04):673–674. PubMed

Hyodo H, Nitsu T, Yoshizawa K, Unno N, Aoki T, Taketani Y. A case of a fetus with gastric perforation associated with congenital diaphragmatic hernia. Ultrasound Obstet Gynecol. 2002;20(05):518–519. PubMed

Esposito C, Settimi A, Centonze A et al.Bochdaleck diaphragmatic hernia, complicated by an antenatal gastric perforation, presenting as a pneumothorax and a perforative peritonitis. Pediatr Surg Int. 2008;24(03):365–369. PubMed

Komuro H, Gotoh C. A case of intrauterine gastric perforation in congenital diaphragmatic hernia. Pediatr Radiol. 2012;42(10):1267–1268. PubMed

Jiang Y, Sun B P, Shi L P. Gastric perforation associated with congenital diaphragmatic hernia in a neonate. Iran J Pediatr. 2013;23(06):712–714. PubMed PMC

Attridge J T, Clark R, Walker M W, Gordon P V. New insights into spontaneous intestinal perforation using a national data set: (1) SIP is associated with early indomethacin exposure. J Perinatol. 2006;26(02):93–99. PubMed

Attridge J T, Clark R, Walker M W, Gordon P V. New insights into spontaneous intestinal perforation using a national data set: (2) two populations of patients with perforations. J Perinatol. 2006;26(03):185–188. PubMed

Pumberger W, Mayr M, Kohlhauser C, Weninger M. Spontaneous localized intestinal perforation in very-low-birth-weight infants: a distinct clinical entity different from necrotizing enterocolitis. J Am Coll Surg. 2002;195(06):796–803. PubMed

Ruano R, Takashi E, da Silva M M, Campos J A, Tannuri U, Zugaib M. Prediction and probability of neonatal outcome in isolated congenital diaphragmatic hernia using multiple ultrasound parameters. Ultrasound Obstet Gynecol. 2012;39(01):42–49. PubMed

Usui N, Kitano Y, Okuyama H et al.Prenatal risk stratification for isolated congenital diaphragmatic hernia: results of a Japanese multicenter study. J Pediatr Surg. 2011;46(10):1873–1880. PubMed

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