TITLE:
Congenital Diaphragmatic Hernia Revealed by an Inaugural Diabetic Ketoacidosis in a 9-Year-Old Child
AUTHORS:
C. Mboutol-Mandavo, E. Moyen, P. Mawandza, G. F. Otiobanda, A. Oko, I. P. L. Ondima, M. Elombila, J.-C. Miéret
KEYWORDS:
Inaugural Diabetic Ketoacidosis, Late-Presenting Congenital Diaphrag-matic Hernia, Child
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.9 No.4,
November
20,
2019
ABSTRACT: Introduction: Congenital diaphragmatic hernia is often detected during the prenatal
or neonatal period by severe respiratory symptoms. Late-presenting congenital
diaphragmatic hernia is uncommon entity resulting in frequent misdiagnosis and
inappropriate treatment. Case Report: We report the case of a left
congenital diaphragmatic hernia revealed by an inaugural diabetic ketoacidosis
in a 9-year-old girl. She has presented progressive weight loss without loss of
appetite associated with polyuro-polydipsia, then epigastric pain with
vomiting. Blood glucose was 3.2 g/L, ketonuria and 2+ glycosuria. Despite a
well-conducted treatment, there was persistence of dyspnea. Chest X-ray and
chest CT-scan confirmed the presence of a left diaphragmatic hernia. Evolution
was marked by the death of the child on day 2 post-operative from a
multivisceral failure. Conclusion: Clinical and radiological signs of
congenital diaphragmatic hernia after the neonatal period may be difficult to
interpret and may result in delayed diagnosis, erroneous treatment and
potentially fatal outcome.