Abstract:
BACKGROUND:Congenital diaphragmatic hernia (CDH) affects 1 in 3000 live births. Modern management strategies include delayed repair of the diaphragm to permit pre-operative optimization of cardiorespiratory status. We describe a cohort of neonates in whom early emergency operative intervention was required for potentially fatal intestinal compromise. METHODS:A retrospective review was performed of all neonatal CDH patients managed at a tertiary center in an 8-year period (2005-2012). RESULTS:A total of 126 CDH patients were managed during the 8-year period. Five neonates (male - 1; gestation 37+4-39+7; birth weight 2.9-3.7kg; left CDH - 5) required emergency operative intervention for presumed gastrointestinal compromise. All five neonates demonstrated systemic hypotension despite inotropic support, raised serum lactate (>2mmol/L), and abnormal radiographic findings. Operative intervention occurred within 3days of birth (1-3days). Findings included gastric volvulus, jejunal volvulus, and perforated caecum. All patients underwent primary diaphragmatic repair without a patch. Temporary ileostomy was required in 1 patient. All patients remain alive. CONCLUSION:Gastrointestinal compromise is a rare, but potentially catastrophic, complication of CDH. Emergency operative intervention may be required in a select cohort of patients. Early deterioration following birth should alert clinicians to the possibility of significant intestinal pathology. LEVEL OF EVIDENCE:Level IV case series with no comparison group.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Fox C,Stewart M,King SK,Patel Ndoi
10.1016/j.jpedsurg.2016.09.012subject
Has Abstractpub_date
2016-12-01 00:00:00pages
1917-1920issue
12eissn
0022-3468issn
1531-5037pii
S0022-3468(16)30335-9journal_volume
51pub_type
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journal_title:Journal of pediatric surgery
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journal_title:Journal of pediatric surgery
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journal_title:Journal of pediatric surgery
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journal_title:Journal of pediatric surgery
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journal_title:Journal of pediatric surgery
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
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journal_title:Journal of pediatric surgery
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journal_title:Journal of pediatric surgery
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journal_title:Journal of pediatric surgery
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.12.018
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abstract::In order to compare the results of renal transplantation in pediatric and adult recipients, a retrospective analysis of first transplants done at a single institution over a 6-yr period was carried out. The study included 21 pediatric and 196 adult recipients of cadaveric grafts, and 18 pediatric and 156 adult recipie...
journal_title:Journal of pediatric surgery
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doi:10.1016/s0022-3468(80)80140-0
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journal_title:Journal of pediatric surgery
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
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journal_title:Journal of pediatric surgery
pub_type: 历史文章,杂志文章
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更新日期:2003-07-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2016-12-01 00:00:00