Congenital diaphragmatic hernia (CDH) generally presents with respiratory distress in the neonatal period. Late onset CDH is less common and is associated with a wide range of clinical symptoms. We report a case of a 4-year-old child presenting with sudden onset of dizziness, abdominal pain and vomiting after swimming. Radiological investigations showed a left CDH with mediastinal shift. She gradually developed respiratory distress after admission. Urgent operation showed that the contents of the hernia included stomach, spleen, small and large bowels. This case highlights the importance of suspicion of CDH, proper clinical examination and investigation of children with acute non-specific gastrointestinal complaints.
Mei-ZahavM., SolomonM., TrachselD., LangerJ.C.Bochdalek diaphragmatic hernia: not only a neonatal disease. Arch Dis Child2003; 88(6): 532–5.
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PautO., MelyL., ViardL., SilicaniM.A., GuysJ.M., CamboulivesJ.Acute presentation of congenital diaphragmatic hernia past the neonatal period: a life threatening emergency. Can J Anaesth1996; 43(6): 621–5.
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ShimizuT., HiraS., HirookaS., YonekuraT., TamaiH.Late onset of right Bochdalek's hernia with strangulation of the omentum. Acta Paediatr2002; 91(4): 483–5.
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