Abstract
Despite advances in antenatal diagnosis and perinatal care, mortality rate remains elevated in patients with congenital diaphragmatic hernia (CDH). We report a case of left sided CDH in a term baby with persistent gastroesophageal reflux (GER) after repair, and persistent pulmonary hypertension requiring multiple vasodilators. Baby required high frequency oscillatory ventilation for 6 weeks. After failed medical management, bedside gastrostomy in neonatal intensive care unit was done. Nissen’s fundoplication was done later. After 2.5 months child was discharged asymptomatically.
Highlights
Congenital diaphragmatic hernia (CDH) is a lifethreatening congenital anomaly with an incidence of 1 in 2,500 live births
Gastroesophageal reflux (GER) is a wellrecognized complication in postoperative patients with CDH which may occur in 30–70% of patients [2], but an incidence of up to 80 % has been reported in patients treated with ECMO before CDH repair
We report a case of CDH complicated by refractory GERD
Summary
Congenital diaphragmatic hernia (CDH) is a lifethreatening congenital anomaly with an incidence of 1 in 2,500 live births. Few studies focused on associated chronic morbidity and long-term outcomes.[1] Gastroesophageal reflux (GER) is a wellrecognized complication in postoperative patients with CDH which may occur in 30–70% of patients [2], but an incidence of up to 80 % has been reported in patients treated with ECMO (extracorporeal membrane oxygenation) before CDH repair. It is reported that 21-60% of CDH patients remain symptomatic after medical treatment, and require anti-reflux surgery.[3] we report a case of CDH complicated by refractory GERD.
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