Congenital Diaphragmatic Hernia with Delayed Diagnosis: Report of Two Cases (Short Report)


Introduction: Advances in prenatal imaging studies have allowed early diagnosis of Congenital Diaphragmatic Hernia (CDH), although neonatal mortality remains at high levels (60% survival). Despite advances, this study found delayed diagnosis, demonstrating subdiagnosis, possibly caused by lack of resources and/or prenatal diagnostic failure. Case Report 1: Infant, 4 months and 22 days old, dyspneic, cyanotic, with fever and vomiting for 3 days, treated as pneumonia. After the second chest radiography, a right CDH was revealed. Surgical correction was performed and removal of Meckel’s diverticulum was surgical findings. The patient was discharged on the 10th days after admission. Case Report 2: Infant, 11 months and 3 days old, distended abdomen, with fever and dyspnea for 2 days, treated as pneumonia. After the second chest radiography, a left CDH was revealed. The patient was submitted to surgery, intestinal loop incarceration without necrosis was observed, and the correction of CDH was performed. The patient was discharged on the 7th day after admission. Discussion: Three cases, between July 2012 and July 2013, were diagnosed at Dom Malam Hospital; 2 Cases of CDH, with delayed diagnosis, showed incidence of 66.66%. Delayed diagnosis of these patients with initial hypotheses of pneumonia demonstrated high risk, emphasizing the importance of diagnosis research through observation of the clinical course, the correct imaging interpretation, in order to establish early diagnosis and treatment.

Share and Cite:

Lemos, S. , Lemos, P. , Coelho, N. , Abrêu, D. and Feitosa, L. (2015) Congenital Diaphragmatic Hernia with Delayed Diagnosis: Report of Two Cases. Case Reports in Clinical Medicine, 4, 114-118. doi: 10.4236/crcm.2015.43025.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Mielniczuk, M., Kusza, K., Brzeziński, P., Jakubczyk, M., Mielniczuk, K. and Czerwionka-Szaflarska, M. (2012) Current Management of Congenital DiaphragmaticHernia. Anaesthesiology Intensive Therapy, 44, 232-237.
[2] Santos, E. and Ribeiro, S. (2008) Hérnia Diafragmática Congénita—artigo de revisao Congenital Diaphragmatic Hernia—A Review. Acta Obstet Ginecol Port, 2, 25-33.
[3] Yap, K.H. and Jones, M. (2013) Late Presentation of Congenital Diaphragmatic Hernia after a Diagnostic Laparoscopic Surgery (a Case Report). Journal of Cardiothoracic Surgery, 8, 8.
[4] Kotecha, S., Barbato, A., Bush, A., Claus, F., Davenport, M., Delacourt, C., Deprest, J., Eber, E., Frenckner, B., Greenough, A., Nicholson, A.G., Antón-Pacheco, J.L. and Midulla, F. (2012) Congenital Diaphragmatic Hernia. European Respiratory Journal, 39, 820-829.
[5] Tsao, K. and Lally, K.P. (2012) Innovations in the Surgical Management of Congenital Diaphragmatic Hernia. Clinics in Perinatology, 39, 363-374.
[6] Michel, F., Baumstarck, K., Gosselin, A., Le Coz, P., Merrot, T., Hassid, S., Chaumoitre, K., Berbis, J., Martin, C. and Auquier, P. (2013) Health-Related Quality of Life and Its Determinants in Children with a Congenital Diaphragmatic Hernia. Orphanet Journal of Rare Diseases, 8, 89.
[7] Partridge, E.A., Bridge, C., Donaher, J.G., Herkert, L.M., Grill, E., Danzer, E., Gerdes, M., Hoffman, C.H., D’Agostino, J.A., Bernbaum, J.C., Rintoul, N.E., Peranteau, W.H., Flake, A.W., Adzick, N.S. and Hedrick, H.L. (2014) Incidence and Factors Associated with Sensorineural and Conductive Hearing Loss among Survivors of Congenital Diaphragmatic Hernia. Journal of Pediatric Surgery, 49, 890-894.
[8] Departamento de Informática do Sistema único de Saúde (Datasus), Ministério da Saúde (MS), Brasil (2014) Informacoes de Saúde. Nascidos vivos.
[9] Leitzke, L., Osório, C.M. and Moretti, G.F. (2007) Diagnóstico Pré-natal de Hérnia Diafragmática Congênita por Imagem de Ressonancia Magnética. ACM Arquivos Catarinenses de Medicina, 36.
[10] Kesieme, E.B. and Kesieme, C.N. (2011) Congenital Diaphragmatic Hernia: Review of Current Concept in Surgical Management. ISRN Surgery, 2011, 8 p.

Copyright © 2021 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.