DOI: http://dx.doi.org/10.18203/2349-2902.isj20202870

Morgagni-Larrey parasternal diaphragmatic hernia masquerading as pleural effusion: an interesting presentation with review of literature

Amit Gupta, Sudhir Kumar Singh, Anshuman Darbari, Durga Sowmya S., Rishit Mani

Abstract


Congenital diaphragmatic hernia (CDH) is a major malformation found in newborns and babies but rarely in adults. CDH is defined by the presence of a defect in the diaphragm, which permits the herniation of abdominal contents into the thorax. The diagnosis of CDH is based on clinical history, examinations and is confirmed by plain X-ray films and computed tomography scans. Here we report a case which was misdiagnosed at another centre as pleural effusion and managed by placement of intercostal tube drainage and later on diagnosed to be case of Morgnani-Larrey parasternal diaphragmatic hernia. Congenital diaphragmatic hernia (CDH) is a major malformation found in newborns and babies but rarely in adults. CDH is defined by the presence of a defect in the diaphragm, which permits the herniation of abdominal contents into the thorax. The diagnosis of CDH is based on clinical history, examinations and is confirmed by plain X-ray films and computed tomography scans. The purpose of reporting this case is to provide information on late-presenting CDH and to emphasize that a high index of suspicion is required for diagnosis and to avoid unwanted complications.


Keywords


Congenital diaphragmatic hernia, Pleural effusion, Laparoscopy

Full Text:

PDF

References


Gattot D, Boda C, Ughetto S, Perthus I, Robert-Gnansia E, Francannet C, et al. Prenatal detection and outcome of congenital diaphragmatic hernia: a French registry-based study. Ultrasound Obstet Gynecol. 2007;29(3):276-83.

Davenport M, Holmes K. Current management of congenital diaphragmatic hernia. Br J Hosp Med. 1995;53(3):95-101.

Sinha CK, Islam S, Patel S, Nicolaides K, Greenough A, Devenport M. Congenital diaphragmatic hernia: prognostic indices in the fetal endoluminal tracheal occlusion era. J Pediatr Surg. 2009;44(2):312-6.

Bronshtein M, Lewit N, Sujov PO, Markoul IR, Blazer S. Prenatal diagnosis of congenital diaphragmatic hernia: timing of visceral herniation and outcome. Pren Diagn. 1995;15(8):695-8.

Gleeson F, Spitz L. Pitfalls in the diagnosis of congenital diaphragmatic hernia. Arch Dis Child. 1991;66(6):670-1.

Numamoglu A, Steiner Z, Millar A, Cywes S. Delayed presentation of congenital diaphragmatic hernia. S Afr J Surg. 1997;35(2):74-6.

Gayer G, Bilik R, Vardi A. CT diagnosis of delayed presentation of congenital diaphragmatic hernia simulating massive leuropneumonia. Eur Radiol. 1999; 9(8):1672-4.

Bianchi E, Mancini P, Stefania DV, Pompili E, Taurone S, Guerrisi I, et al. Congenital asymptomatic diaphragmatic hernias in adults: a case series. J Med Case Report. 2013;7(1):125.

Nakayama DK, Harrison MR, Chrinn DH, Callen PW, Filly RA, Golbus MS, et al. Prenatal diagnosis and natural history of the fetus with a congenital diaphragmatic hernia: initial clinical experience. J Pediatr Surg. 1985, 20(2):118-24.

Sridhar AV, Nichani S. Late presenting congenital diaphragmatic hernia. Emerg Med J. 2004;21(2):261-2.

Baerg J, Kanthimathinathan V, Gollin G. Late-presenting congenital diaphragmatic hernia: diagnostic pitfalls and outcome. Hernia. 2012;16(4):461-6.

Wilbur AC, Gorodetsky A, Hibbeln JF. Imaging findings of adult Bochdalek hernias. Clin Imaging. 1994;18(3):224-9.

Yilmaz M, Isik B, Coban S, Sogutlu G, Ara C, Kirimlioglu V, et al. Transabdominal approach in the surgical management of Morgagni hernia. Surg Today. 2007;37:9-13.