Congenital Diaphragmatic Hernia in Children

Abstract

Objective:   To study  the presentation,  results  and  complications  of  management of congenital diaphragmatic hernia in children at our setup.

Study Design: Retrospective Descriptive Study.

Place & Duration of Study: This study was conducted in the department  of  Paediatric Surgery,  Children  Hospital &  The Institute of  Child Health,  Multan  during a  period of three years from January 2008 to December 2010.
Materials and Methods:  A total of 25 patients with congenital diaphragmatic hernia were managed. Data was collected on the basis of history, clinical examination, relevant investigations, operative results and complications.  Final analysis was made at the completion of study.

Results:   Study included  25  consecutive  cases with ages ranging from 12 hours to 7 months.  19 (76%)  were  male  and  6  (24%)  female.   20 (80%)  were  neonates   with predominant  symptoms  of  respiratory  distress  since  birth  along  with   cyanosis and apnoeic  spells.  Five ( 20%)   patients   were   beyond   the   age  of   one   month   with predominant  symptoms of   recurrent  respiratory  tract infection, vomiting and failure to thrive. Clinical signs included absence of breath sounds, presence of bowel sounds and impaired resonance on affected  side of chest in all 25 (100%) patients. Flat abdomen in 18 (72%) and cachexia in 2(8%). Left side involvement was in 22 (88%) and right side in 3 (12%).  All   the  patients  were operated  upon.  Conventional  mechanical  ventilation (CMV)  was  given  to 16(64%). One (4%) patient died and rest of the 24(96%) survived.

Conclusion:  Best possible  operative  results  can be  obtained  with the help of limited facilities present in our setup.