VP10.05: Congenital eventration or diaphgramtic hernia: a dilemma?

Abstract

Congenital eventration of the diaphragm is a rare prenatal diagnosis often confused with congenital diaphragmatic hernia. We present a case of a 26 year old second gravida, refered to us with congenital diaphragmatic hernia at 19 weeks. A scan at our centre revealed mesocardia with stomach and liver in normal position with suspicion of a solid structure with slighlly less echogenecity than lungs in left hemtihorax. Scan on the next day showed a change with the heart in distinct dextroposition being pushed by spleen in the left hemithorax cnfirmed with fetal MRI. Fetal echocardiography was normal and no other anomaly was found. After counselling the parents opted for amniocentesis and decided to continue the pregnancy. The karyotype was normal. CMA was not done due to financial constraints. The fetus was followed 2 weekly, with no further change in findings noted. Fetal growth was appropriate though mother developed gestational diabetes. She delivered a male baby weighing 2810 gm at 36+5 weeks by Caesarean section done for abnormal CTG. Apgar score at birth was 9, 9 with no need of neonatal intervention for respiratory or feeding difficulties. Postnatal chest Xray revealed a tenting of left hemidiaphragm with shifting of heart to the right side. The baby is currently 6 weeks old and thriving well. Congenital eventration of diaphragm may have a better prognosis than congenital diaphragmatic hernia. It is important to keep this diagnosis in mind when counselling the patients . Absence of stomach or liver in the thorax with varying position of the heart could be a pointer more towards eventration than hernial defect of diaphragm. Supporting information can be found in the online version of this abstract Supporting Information Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.