Pediatr Rep

. 2022 Mar 11;14(1):140-146. doi: 10.3390/pediatric14010020. https://pubmed.ncbi.nlm.nih.gov/35324823/

Ingrowing Liver as Atypical Recurrent Diaphragmatic Hernia Presentation-Diagnostic and Treatment Difficulties: A Case Report

Dominika Borselle ¹, Krzysztof Międzybrodzki ², Sylwester Gerus ¹, Urszula Zaleska-Dorobisz ², Agnieszka Hałoń ³, Leszek Szenborn ⁴, Dariusz Patkowski ¹Affiliations expand

• PMID: 35324823
• PMCID: PMC8948779
• DOI: 10.3390/pediatric14010020

Free PMC article

Abstract

(1) Introduction: Recurrent diaphragmatic hernia is a relevant diagnostic and treatment dilemma. We have presented a patient with ingrowing liver as an atypical diaphragmatic hernia recurrence and discussed major aspects of diagnostic methods and the selection of an appropriate operative treatment. (2) Case description: We discuss a case of a patient with right-sided recurrent CDH (Congenital Diaphragmatic Hernia) who had primary thoracoscopic repair in newborn period. During infancy and early childhood, the patient presented recurrent upper and lower respiratory tract infections and bronchial hyperreactivity. The clinical picture was initially unclear. A CT scan was inconclusive to diagnose a recurrence. The patient was scheduled to have a re-thoracoscopy. A part of the liver was herniated into the pleural cavity. This fragment of ‘ingrowing’ liver was removed, and the diaphragmatic secondary defect was repaired. (3) Conclusions: This case proved that thoracoscopy can be a preferred technique in the diagnosis and treatment of CDH recurrence.

Keywords: CDH recurrence; ingrowing liver; minimally invasive surgery; thoracoscopy.