Peri Operative Management of a Simultaneously Symptomatic Diaphragmatic Hernia and Imperforate Anus in a Neonate: A Rare but Challenging Combination

Ashani Ratnayake

doi:10.34297/ajbsr.2021.14.001969

Abstract

Peri Operative Management of a Simultaneously Symptomatic Diaphragmatic Hernia and Imperforate Anus in a Neonate: A Rare but Challenging Combination

Highlights

Congenital diaphragmatic hernia (CDH) is a rare condition with an incidence of 1 in 2000-4000 live births [1]
A chest Xray was taken after inserting a nasogastric tube, confirmed the diagnosis of left sided diaphragmatic hernia (Figure 3)
A decision was made to go ahead with the surgical correction. During this this time he fulfilled the criteria for CDH EURO consortium except high lactate level. 48 hours after birth repair of congenital diaphragmatic hernia (CDH) and colostomy creation was done under general anaesthesia

Summary

Introduction

Congenital diaphragmatic hernia (CDH) is a rare condition with an incidence of 1 in 2000-4000 live births [1]. A chest Xray was taken after inserting a nasogastric tube, confirmed the diagnosis of left sided diaphragmatic hernia (Figure 3). The neonate was continued on ventilatory support with intravenous MgSO4 and NG Sildenafil for the management of persistent pulmonary hypertension which is common in this population. A decision was made to go ahead with the surgical correction During this this time he fulfilled the criteria for CDH EURO consortium except high lactate level. The ventilatory requirements increased in the immediate post operative period, with a left sided pleural effusion which was managed with an intercostals tube. Patient required prolong ventilatory support with the development of pleural effusion and bronchopneumonia.

Discussion

Conclusion