Abstract | INTRODUCTION: CASE PRESENTATION: We describe the case of a 7-year-old Middle Eastern girl who presented with acute nonspecific abdominal symptoms and respiratory distress of 2 days' duration after sustaining a blunt trauma on her left chest wall on a background of chronic ill-defined left chest pain of 2 weeks' duration. Her initial chest radiograph showed an air-fluid level, which was thought to be a hydropneumothorax, so a chest tube was inserted and was shown to be positioned between the chest wall and the air collection; therefore, a nasogastric tube was inserted and it was positioned in the left chest cavity so the diagnosis of late-onset congenital diaphragmatic hernia was made. On retrospective analysis of the first abdominal X-ray, it showed a subtle lucent area that was triangular in shape and continued with the chest cavity, which indicates a sign of diaphragmatic hernia. In addition, the next unusual point was the nonvisualization of the diaphragm, which should be reported in any abdominal X-ray. An exploratory laparotomy was performed on our patient using a left-sided subcostal incision; the operative findings revealed a very small posterior rim of the diaphragm and a hypoplastic left lung. Her stomach, spleen, and left colon with the omentum were in the left side of her chest. She made an uneventful recovery postoperatively and was discharged after 1 week. CONCLUSIONS:
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Authors | Vassil Nikolov Zefov, Maryam Anas Almatrooshi |
Journal | Journal of medical case reports
(J Med Case Rep)
Vol. 9
Pg. 291
(Dec 22 2015)
ISSN: 1752-1947 [Electronic] England |
PMID | 26695937
(Publication Type: Case Reports, Journal Article)
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Topics |
- Abdominal Pain
(etiology)
- Chest Pain
(etiology)
- Child
- Diagnosis, Differential
- Female
- Hernias, Diaphragmatic, Congenital
(diagnosis, surgery)
- Humans
- Hydropneumothorax
(diagnosis)
- Radiography, Thoracic
- Time Factors
- Treatment Outcome
- Wounds, Nonpenetrating
(pathology)
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