Unusual Congenital Diaphragmatic Hernia: Report of a Case

罕見的先天性橫膈疝氣：病例報告

張繼仁(Chi-Jen Chang) ； 葉明倫(Ming-Lun Yeh)

《Formosan Journal of Surgery》 37卷5期 (2004/10) Pp. 234-237

https://doi.org/10.29833/FJS.200410.0007

摘要

先天性橫膈疝氣（Congenital Diaphragmatic Hernia）常發生於新生兒，其中以後外側或Bochdalek疝氣為最常見，且其臨床表現較早，往往在出生後即有呼吸窘迫與發紺而需要緊急治療。雖然大部分病兒可獲得治療，但由於常合併肺發育不全，而有相當高的死亡率。一位一歲五個月大的小男孩，出生時都很正常，在十個月大時，因為咳嗽、發燒到本院門診求診。當時照的胸部X光並無異常，診斷為肺炎，並給予口服抗生素治療及門診追蹤。
小男孩在一歲五個月大時，斷斷續續的咳嗽一個星期，且呼吸急促，發燒2天，當時送到本院急診求診。胸部X光及電腦斷層證實為先天性橫膈疝氣（CDH)，緊急安排手術，病患在完成橫膈膜修補術後，10天痊癒出院。因為很少有病患的胸部X光剛開始表現是正常，之後才發現為先天性橫膈疝氣的案例，我們回顧了相關了文獻並提出病例報告。

並列摘要

Congenital diaphragmatic hernia (CDII) is most often observed in newborns. Patients with posterolateral or Bochdalek hernia often appear dyspneic and cyanotic shortly after birth and require emergent treatment. Although there may be late presentations of CDH, most diaphragmatic abnormalities can be found on the initial chest X-rays. An unusual case of CDH with an initial normal chest X-ray is presented. This patient had an episode of bronchopneumonia at 10 months of age. At that time, there was no diaphragmatic abnormalities on his chest X-ray. When the boy was 17 months old, he had intermittent cough for 1 week, and dyspnea and fever for 2 days. The chest X-ray and computed tomography revealed that he had left-sided CDH, and repair of the hernia defect was performed successfully. He recovered well and was discharged from the hospital 10 days later.

並列關鍵字

congenital diaphragmatic hernia