Taiwan J Obstet Gynecol

. 2021 Mar;60(2):370-372. doi: 10.1016/j.tjog.2021.01.020. https://pubmed.ncbi.nlm.nih.gov/33678346/

Prenatal diagnosis of left side congenital diaphragmatic hernia associated with gastric perforation

Teck-Sian Tan ¹, Chie-Pein Chen ¹, Chen-Yu Chen ²Affiliations expand

• PMID: 33678346
• DOI: 10.1016/j.tjog.2021.01.020

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Abstract

Objective: A congenital diaphragmatic hernia (CDH) complicated with gastric perforation is extremely rare. Herein, we report an unusual case of unexpected intrauterine gastric perforation of a left side CDH with concurrent pleural effusion and ascites.

Case report: A 21-year-old female underwent prenatal ultrasound at 37 weeks of gestation and revealed a left side CDH, pleural effusion with a large thick-walled cystic mass over the left thorax, ascites, and polyhydramnios. Under the impression of CDH with suspected gastric perforation, Cesarean delivery was arranged and a male neonate was delivered. The neonate received emergency laparotomy soon and a herniation originated from the foramen of Bochdalek and a perforation located in the stomach body along the greater curvature were found. The pathologic diagnosis was consistent with a spontaneous gastric perforation with ischemic change.

Conclusion: Sonographic findings of pleural effusion and ascites associated with CDH are clues of antenatal gastrointestinal perforation.

Keywords: Congenital diaphragmatic hernia; Intrauterine gastric perforation; Prenatal diagnosis.

Copyright © 2021. Published by Elsevier B.V.