Dual Chest Pathology Presenting with Acute Respiratory Failure: A Case Report and Review of Literature

Ahmed Nabil Abdelhadi,Khaled Zamel Aldaraan,Mohamed Hany Hassab,Muhammad Elsayed Abdelhafez Mahmoud

doi:10.31487/j.ajscr.2020.01.09

Abstract

Congenital diaphragmatic hernia (CDH) is an uncommon neonatal pediatric surgical problem. About 5-25% of cases had delayed presentation, making diagnostic challenge and requiring a high index of suspicion. Combination of diaphragmatic hernia and severe pneumonia with rapid deterioration of the case up to respiratory failure is a rare occasion. Herein, we present a case of 2-years-old female referred to our hospital intubated, ventilated due to type 2 respiratory failure resulting from dual chest pathology (severe pneumonia and left sided congenital diaphragmatic hernia). She was admitted at the pediatric intensive care unit (PICU), stabilized then operated for repair of her diaphragmatic hernia. Post-operatively, she remained intubated, ventilated for 7 days then weaned gradually from the ventilator. The cardiorespiratory status has much improved and she started oral feeding by the 8th post-operative day and discharged home in a stable condition.

Highlights

Congenital diaphragmatic hernia (CDH) refers to a congenital defect in the posterolateral diaphragm at the “Foramen of Bochdalek.” It is a relatively common cause of neonatal respiratory distress with an overall incidence of 1:3000 (1 in 2000-5000) live births, about 33% of cases are stillborn [1, 2]
Dual Chest Pathology Presenting with Acute Respiratory Failure: A Case Report and Review of Literature
We present a case of 2-years-old female referred to our hospital intubated, ventilated due to type 2 respiratory failure resulting from dual chest pathology

Summary

Introduction

Congenital diaphragmatic hernia (CDH) refers to a congenital defect in the posterolateral diaphragm at the “Foramen of Bochdalek.” It is a relatively common cause of neonatal respiratory distress with an overall incidence of 1:3000 (1 in 2000-5000) live births, about 33% of cases are stillborn (it predominates in females if stillborn fetuses are counted) [1, 2]. Dual Chest Pathology Presenting with Acute Respiratory Failure: A Case Report and Review of Literature Combination of diaphragmatic hernia and severe pneumonia with rapid deterioration of the case up to respiratory failure is a rare occasion.

Results

Conclusion