Clinical Presentation and Radiographic Diagnosis of Non-traumatic Childhood Diaphragmatic Hernia
摘要
Between years 1993 and 2002, a total of 90 patients were diagnosed as diaphragmatic hernia in our hospital. Excluding 2 cases with traumatic diaphragmatic hernia, there were 15 cases (17.0 %, 15/88) with non-traumatic diaphragmatic hernia in childhood (13 Bochdalek hernias and 2 Morgagni hernias) that presented beyond the neonatal period. All of the 15 patients were without major symptoms in the neonatal period. These patients with childhood diaphragmatic hernia might be asymptomatic or present with various gastrointestinal or respiratory symptoms. Nearly half of the patients (46.7%) had hernia sac found at surgery, which might imply a postnatal cause rather than congenital in a substantial proportion of childhood diaphragmatic hernia. Radiography is the most important imaging modality but may not be adequate for accurate diagnosis in some patients. Barium study was performed in 6 patients and always led to accurate diagnosis in our series. The prognosis of childhood diaphragmatic hernia is good since there is little or no pulmonary hypoplasia. However, delayed diagnosis and treatment may result in life-threatening complications. In this article we discuss the clinical and imaging presentation of childhood diaphragmatic hernia.