Outcomes Following Management of Congenital and Acquired Diaphragmatic Hernia in a Tertiary Care Centre: A Case Series

Abstract

Saikalyan A Guptha*, Ravikumar H, Sidduraj C Sajjan, Tinnu George, Karthik HS and Harshita R

Introduction: Congenital Diaphragmatic Hernia (CDH) is a congenital abnormality, frequently seen in children. With the advent of prenatal ultrasound, it is diagnosed prenatally and corrected in the pediatric age. Rarely adults present to the emergency room with congenital diaphragmatic hernia. Traumatic diaphragmatic hernia is also not unheard of and seen in a wide variety of blunt trauma injuries in road traffic accidents. Congenital diaphragmatic hernia occurs in 1 in 2,200 to 5000 live births. Early diagnosis and prompt surgical intervention results in positive outcomes. This article will provide our experience with the diaphragmatic hernia and the outcomes.

Methods: From 2018 to 2021, five patients of diaphragmatic hernia were admitted to the Vydehi Hospital. Patients underwent successful surgery to treat the diaphragmatic hernia. They were operated by the same team of surgeons. The presentation of each patient, difficulties in each case, the treatment provided and the outcomes following the surgery is described in this article, with facts reviewed from the hospital medical records.

Results: Case 1 presented with a Bochdalek hernia with right kidney as content. Case 2 presented with gastric volvulus and splenic flexure of colon as content. Case 3 presented with traumatic diaphragamatic hernia with stomach as content of hernia. Case 4 presented with adult congenital diaphragmatic hernia with small bowel and part of large bowel as content. Case 5 presented with Bochdalek hernia with transverse colon, spleen, fundus of the stomach, omentum, and part of small bowel as the content.

Conclusion: Adult Congenital Diaphragmatic Hernia is a very unusual presentation. Prenatal ultrasound allows for early diagnosis. Pulmonary hypertension and pulmonary hypoplasia if present reduces the survival chances. Patients who present in their adulthood with congenital diaphragmatic hernia need surgical correction.