INTERESTING CASE

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INTERESTING CASE ROUND

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What is your diagnosis?
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Diagnosis Eventration of diaphragm vs
diaphragmatic hernia
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• ?? persistent pneumonia ???????????????
• What is your diagnosis and plan of management ?

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? Dx Diaphragmatic hernia, most likely Morgagni
hernia
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Diaphragmatic Deformities
Congenital Diaphragmatic Hernia of Bochdalek
Congenital Anterior Diaphragmatic
Hernia (Morgagni Hernia)
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Congenital Diaphragmatic Hernia of Bochdalek
Posterolateral diaphragmatic hernia through the
pleuroperitoneal sinus is perhaps the most urgent
of all neonatal thoracoabdominal
emergencies. The maldevelopment is left-sided in
85 to 90 of the cases.
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Congenital Diaphragmatic Hernia
of Bochdalek
Diagnosis in NB Immediate cardio-respiratory
distress, does not clear with pharyngotracheal
cleaning. Fairly constant cyanosis, dyspnea,
tachypnea, and tachycardia The involved
hemithorax is relatively protuberant. Chest
expansion is bilaterally uneven.
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Congenital Diaphragmatic Hernia
of Bochdalek
Diagnosis in NB Breath sounds are absent on the
left, and percussion may be resonant. It is
unusual to hear thoracic peristalsis. The apical
cardiac impulse is dislocated to the right. The
abdomen is scaphoid.
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Congenital Anterior Diaphragmatic
Hernia (Morgagni Hernia)
Morgagni hernias occur behind the sternum
through defects in the diaphragm that are
perhaps secondary to a developmental failure of
the retrosternal segment of the septum
transversum.
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Congenital Anterior Diaphragmatic
Hernia (Morgagni Hernia)
The defect on the left is usually obliterated by
pericardium therefore, most of the hernias are on
the right. It many infants and children,
anterior diaphragmatic defects are asymptomatic,
and the hernia is found incidentally on chest
roentgenogram.
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Congenital Anterior Diaphragmatic
Hernia (Morgagni Hernia)
The diagnosis may be ultimately supported by
roentgenograms showing a moderately dense tumor,
usually at the right cardiophrenic angle in the
posteroanterior film and in the anterior
mediastinum on the lateral view.