Abstract

A 3-month-old female infant presented with vomiting for 1-month, poor feeding and lethargy for few days with history of fever at home. On examination was noted to be lethargic, hypoxic, tachypnoeic with recessions and poor air entry and cold extremities. She was resuscitated with oxygen and fluids and was being treated for suspected sepsis. A chest X-ray (CXR) showed bowel loops in the left hemi thorax confirming the diagnosis of congenital diaphragmatic hernia (CDH). The infant was subsequently transferred to a tertiary centre where the defect was surgically corrected. This case report highlights the difficulty in suspecting and diagnosing late presenting CDH after the neonatal period.

Highlights

  • A 3-month-old female infant presented with vomiting for 1-month, poor feeding and lethargy for few days with history of fever at home

  • No.1:2 (A&E) department with worsening vomiting over a month that was initially milky and later became slightly Discussion green stained. She was less active, feeding poorly and was felt to be hot at home. She was born at term after an uneventful congenital diaphragmatic hernia (CDH) is an anomaly with an incidence of about 2.7 per 10000 live birth [1]

  • It and no family history of significance. 4 weeks prior to this implies a defect in the diaphragm through which abdominal viscera presentation, she was seen at her local hospital with vomiting can herniate into the chest

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Summary

Introduction

A 3-month-old female infant presented with vomiting for 1-month, poor feeding and lethargy for few days with history of fever at home. Pediatr Emerg Care Med Open Access Vol.5 No.1:2 (A&E) department (referred by their GP) with worsening vomiting over a month that was initially milky and later became slightly Discussion green stained. She was born at term after an uneventful CDH is an anomaly with an incidence (that varies based on the pregnancy with normal antenatal scans at 20 weeks of gestation population being studied) of about 2.7 per 10000 live birth [1]. 4 weeks prior to this implies a defect in the diaphragm through which abdominal viscera presentation, she was seen at her local hospital with vomiting can herniate into the chest.

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