Intestinal Perforation during the Stabilization Period in a Preterm Infant with Congenital Diaphragmatic Hernia
Status PubMed-not-MEDLINE Language English Country Germany Media print-electronic
Document type Case Reports, Journal Article
PubMed
28868233
PubMed Central
PMC5578864
DOI
10.1055/s-0037-1606288
PII: 160303cr
Knihovny.cz E-resources
- Keywords
- bowel perforation, congenital diaphragmatic hernia, delayed surgery,
- Publication type
- Journal Article MeSH
- Case Reports MeSH
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.
3rd Faculty of Medicine Charles University Prague Czech Republic
Department of Pediatric Surgery 2nd Faculty of Medicine Charles University Prague Czech Republic
Fetal Medicine Centre Institute for the Care of Mother and Child Prague Czech Republic
See more in PubMed
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