BACKGROUND: Congential diaphragmatic herniae pose serious challenges in their management in this environment.Aim & Objective: To determine the pattern, as well as the diagnostic and management challenges of congenital diaphragmatic hernia in Dakar, Senegal. PATIENTS AND METHODS: This is a retrospective review of 14 children with congenital diaphragmatic hernia (CDH) managed within eleven years in Dakar, Senegal. RESULTS: There were nine boys and five girls with the age range of one day to 22 months and a mean of 5 months. Respiratory signs (respiratory distress, cough, current pulmonary infection) were found in 13 patients and gastrointestinal symptoms (vomiting, Difficulty sucking, anorexia) in 6 patients. The thoracic-abdominal radiography was performed in all patients and revealed a Bochdalek hernia on the left in 10(71%) cases and 4(29%) were Morgagni hernia. Treatment was by repair of the diaphragmatic defect with non-absorbable sutures. The postoperative course was uneventful in 13 children while one patient died on the first postoperative day one. CONCLUSION: Congenital diaphragmatic hernia presents mainly with postnatal respiratory features in this setting. Thoracic-abdominal radiography allows for early diagnosis, prompt and effective treatment with good outcome. KEYWORDS: Congenital diaphragmatic hernia, Respiratory insufficiency, Radiological features, Good surgical outcome.
BACKGROUND: Congential diaphragmatic herniae pose serious challenges in their management in this environment.Aim & Objective: To determine the pattern, as well as the diagnostic and management challenges of congenital diaphragmatic hernia in Dakar, Senegal. PATIENTS AND METHODS: This is a retrospective review of 14 children with congenital diaphragmatic hernia (CDH) managed within eleven years in Dakar, Senegal. RESULTS: There were nine boys and five girls with the age range of one day to 22 months and a mean of 5 months. Respiratory signs (respiratory distress, cough, current pulmonary infection) were found in 13 patients and gastrointestinal symptoms (vomiting, Difficulty sucking, anorexia) in 6 patients. The thoracic-abdominal radiography was performed in all patients and revealed a Bochdalek hernia on the left in 10(71%) cases and 4(29%) were Morgagni hernia. Treatment was by repair of the diaphragmatic defect with non-absorbable sutures. The postoperative course was uneventful in 13 children while one patient died on the first postoperative day one. CONCLUSION:Congenital diaphragmatic hernia presents mainly with postnatal respiratory features in this setting. Thoracic-abdominal radiography allows for early diagnosis, prompt and effective treatment with good outcome. KEYWORDS: Congenital diaphragmatic hernia, Respiratory insufficiency, Radiological features, Good surgical outcome.
Authors: Saskia J Gischler; Monique H M van der Cammen-van Zijp; Petra Mazer; Gerard C Madern; Nikolaas M A Bax; Johan C de Jongste; Monique van Dijk; Dick Tibboel; Hanneke Ijsselstijn Journal: J Pediatr Surg Date: 2009-09 Impact factor: 2.545