Congenital Diaphragmatic Hernia presenting after the Neonatal Period

Abstract

Summary:

Four cases of congenital diaphragmatic hernia (CDH), presenting after the neonatal period, at the Obafemi Awolowo University Teaching Hospitals Complex over a 12-year period (1983 - 1996), are reported. All the children were males, with a mean age of presentation, of six months (range, three - 11 months). Two of the CDH were through a right postero-lateral defect, one was through a left postero-lateral defect while the fourth was through a central defect in the dia phragm. The four children had persistent respiratory distress starting from birth and this was associated with pectus excavatum in the boy with the central diaphragmatic defect. Chest radi ography and upper gastrointestinal contrast studies were diagnostic in three cases. Three of the four children had successful surgical repairs and although one of them later died from measles infection, the other two were in good health and thriving over a follow-up period ranging be tween three and 30 months. Our experience shows that CDH presenting after the neonatal pe riod, poses less challenges in management if the diagnosis is made early and appropriate treat ment instituted.