2 week old female delivered by cesarean section on account of pregnancy induced hypertension . Apgars 5 and 8. Baby was found to be in respiratory distress at birth and cyanosed
RR-60, .HR-130, CRT 2s, RBS 5.4mmol /l, Hb-19.5, WBC 11.5, BUN : 1.5mmol , Creatinine-32umol /l
Examination :.Auscultation of the chest revealed bowel sounds over left hemithorax. Reduced air entry on the right lung field
Diagnosis : Congenital diaphragmatic hernia .
Surgery: Through an extended left upper quadrant abdominal incision used laparotomy performed. Viscera reduced and defect measuring (12*8)cm in the posterolateral diaphragm repaired with nylon 3/0
Heart had no pericardium and was displaced to the right. Herniated bowel included omentum, stomach, spleen, small and large bowel. Large defect in posterolateral part of left hemidiaphragm extending to the right.
Patient made excellent recovery postoperatively
Credits : Dr Michael Amoah Paediatric surgeon and Dr Afrifa surgery resident. KATH, Kumasi