Misdiagnosis in delayed presentation left bochdalek hernia
Geç tanı alan konjenital diyafram hernilerinde farklı klinik bulgular görülmektedir. Gastrointestinal veya solunum sistemi ile ilgili bulgular vardır. Sol taraf hernilerde gastrointestinal bulgular ön plandayken sağ taraf hernilerde solunum sistemi ile ilgili klinik bulgular daha belirgindir. Acil ameliyat nadiren gerekir. Kliniğimizde geç tanı alan sol Bochdalek hernili üç vakayı değerlendirdik.
Geç saptanmış sol bochdalek hernisinde yanlış tanı
Late-presenting congenital diaphragmatic hernias represent a considerable diagnostic challenge. Presenting symptoms could be related to respiratory or gastrointestinal systems. Presentation with gastrointestinal problems is more common in left sided hernias, whereas respiratory symptoms are more prominent in right-sided lesions. Emergency operation is rarely required. Here, we report three patients with late onset left Bochdalek hernia who presented with respiratory problems and abnormal chest x-rays.
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- 1. Kitano Y, Lally KP, Lally PA; Congenital Diaphragmatic Hernia Study Group. Late-presenting congenital diaphragmatic hernia. J Pediatr Surg 2005; 40: 1839-43. [CossRef]
- 2. Keles S, Artac H, Elmaci M, Reisli I, Dilsiz A. Late-presenting Congenital Diaphragmatic Hernia Associated with Ectopic Thoracic Kidney. Eur J Pediatr 2006; 165: 571-2. [CossRef]
- 3. Elhalaby EA, Sikeena MA. Delayed Presentation of Congenital Diaphragmatic Hernia. Pediatr Surg Int 2002; 18: 480-5. [CossRef]
- 4. Robb BW, Redd MF. Congenital Diaphragmatic Hernia Presenting as Splenic Rupture in an Adult. Ann Thorac Surg 2006; 81: e9-10. [CossRef]
- 5. Vukic Z. Left Bochdalek Hernia with Delayed Presentation: Report of Two Cases. Croat Med J 2001; 42: 569-71.
- 6. Ozturk H, Karnak I, Sakarya MT, Cetinkursun S. Late Presentation of Bochdalek Hernia: Clinical and Radiological Aspects. Pediatr Pulmonol 2001; 31: 306-10. [CossRef]
- 7. Barsness KA, Bensard DD, Ciesla D, Partrick DA, Hendrickson R, Karrer FM. Blunt Diaphragmatic Rupture in Children. J Trauma 2004; 56: 80-2. [CossRef]
- 8. Berman L, Stringer D, Ein SH, Shandling B. The Late Presenting Pediatric Bochdalec Hernia: A 20-year review. J. Pediatr Surg 1988; 23: 735-9. [CossRef]
- 9. Mei-Zahav M, Solomon M, Trachsel D, Langer JC. Bochdalek Diaphragmatic Hernia: Not Only a Neonatal Disease. Arch Dis Child 2003; 88: 532-5. [CossRef]
- 10. Nadroo AM, Levshina R, Tugertimur A, Gudavalli M, Raziuddin K. Congenital Diaphragmatic Hernia: Atypical Presentation. J Perinat Med 1999; 27: 276-8. [CossRef]