2005-02-28-12 Diaphragmatic hernia, Left-sided © Gourand www.thefetus.net/
Diaphragmatic hernia, left-sided
Luc Gourand, MD1, Evelyne Petroff, MD 1, François Jacquemard, MD 2, Geneviève Brodaty, MD 2, Nadia Léticée, MD 2, Fernand Daffos, MD 2, Hélène Martelli, MD 3, Danièle Pariente, MD3
1 Les Bluets Maternité, Paris, 2 Institut de Puériculture Paris, Médecine Foetale, 3 Le Kremlin-Bicêtre, Chirurgie pédiatrique
Because of its happy outcome, this new case of left-sided diaphragmatic hernia is published thanks to the baby s parents as a message of hope to other parents.
G2, P1, 30 years with no previous history. Normal scans at 13 and 24 weeks (stomach seen in the usual position).
Left diaphragmatic hernia discovered at 34 weeks on routine scan with the following findings:
The stomach, part of the small intestine and the spleen are seen in the left part of the thorax beside the heart which is displaced to the right. The left lung is visualised above the hernia. No associated anomaly. Amniotic fluid volume normal (no poyhydramnios). Normal breathing movements. Normal echocardiography. Normal karyotyope 46 XY.
in utero breathing post natal chest X ray (courtesy of Danièle Pariente) demonstrating the left thoracic hernia
A scheduled cesarean section is performed at 38 weeks and 5 days, a baby boy is delivered: 3370 g, Apgar 8/10/10, immediate tracheal intubation, no respiratory distress, condition stable. Surgical intervention at H 24.
Photographs of the surgical procedure (courtesy of Hélène Martelli): the five centimeters Bochdalek hernia, abdominal reintegration of the stomach, part of the left hepatic lobe, small intestine and spleen. The left lung looks in good condition. Surgical repair of the hernia. Appendicectomy. Treatment of the mesenterium communae.
post operative chest X ray
This healthy baby boy was discharged from hospital on day 10. Uneventful follow-up.
This (with his parents permission) is his picture at 3 months: