Death by late presenting of diaphragmatic hernia in an infant: case report and review of the literature.

Autor: Ben Abderrahim S; Ibn El Jazzar Faculty of Medicine, The University of Sousse, Mohamed Karoui street, 4002 Sousse, Tunisia.; Department of Forensic Medicine, Farhat Hached University Hospital, Ibn El Jazzar street, 4000 Sousse, Tunisia., Jedidi M; Ibn El Jazzar Faculty of Medicine, The University of Sousse, Mohamed Karoui street, 4002 Sousse, Tunisia.; Department of Forensic Medicine, Farhat Hached University Hospital, Ibn El Jazzar street, 4000 Sousse, Tunisia., Ben Daly A; Ibn El Jazzar Faculty of Medicine, The University of Sousse, Mohamed Karoui street, 4002 Sousse, Tunisia.; Department of Forensic Medicine, Farhat Hached University Hospital, Ibn El Jazzar street, 4000 Sousse, Tunisia., Nfikha Z; Ibn El Jazzar Faculty of Medicine, The University of Sousse, Mohamed Karoui street, 4002 Sousse, Tunisia.; Department of Pathological Anatomy and Cytology, Farhat Hached University Hospital, Ibn El Jazzar street, 4000 Sousse, Tunisia., Ben Dhiab M; Ibn El Jazzar Faculty of Medicine, The University of Sousse, Mohamed Karoui street, 4002 Sousse, Tunisia.; Department of Forensic Medicine, Farhat Hached University Hospital, Ibn El Jazzar street, 4000 Sousse, Tunisia., Zemni M; Ibn El Jazzar Faculty of Medicine, The University of Sousse, Mohamed Karoui street, 4002 Sousse, Tunisia.; Department of Forensic Medicine, Farhat Hached University Hospital, Ibn El Jazzar street, 4000 Sousse, Tunisia., Mokni M; Ibn El Jazzar Faculty of Medicine, The University of Sousse, Mohamed Karoui street, 4002 Sousse, Tunisia.; Department of Pathological Anatomy and Cytology, Farhat Hached University Hospital, Ibn El Jazzar street, 4000 Sousse, Tunisia., Souguir MK; Ibn El Jazzar Faculty of Medicine, The University of Sousse, Mohamed Karoui street, 4002 Sousse, Tunisia.; Department of Forensic Medicine, Farhat Hached University Hospital, Ibn El Jazzar street, 4000 Sousse, Tunisia.
Jazyk: angličtina
Zdroj: Egyptian journal of forensic sciences [Egypt J Forensic Sci] 2022; Vol. 12 (1), pp. 39. Date of Electronic Publication: 2022 Sep 21.
DOI: 10.1186/s41935-022-00299-x
Abstrakt: Background: Congenital diaphragmatic hernia (CDH) is a congenital malformation of the diaphragm, resulting in the herniation of the abdominal organs into the thoracic cavity. If not properly diagnosed before or at birth, CDH represents a life-threatening pathology in infants and a major cause of death. We present a fatal case of congenital diaphragmatic hernia corresponding to Bochdalek hernia, discovered incidentally during a sudden death's autopsy of an infant. To achieve a better view of the range of these anomalies, we also conducted a literature review on this subject describing the pathogenesis, manifestations, diagnosis, and autopsy contribution to addressing these CDH.
Case Presentation: The case involved a 4-month-old female infant who presented sudden respiratory difficulties after breastfeeding. External examination found marked cyanosis with no evidence of trauma. Upon opening the chest cavity, the stomach, markedly distended, was occupying much of the left pleural cavity. The left lung was compressed and displaced superiorly, and the heart was also compressed and deviated to the right. This mediastinal deviation was due to an ascension of the stomach into the chest cavity through a 2 × 1.5 cm defect in the posterior left hemidiaphragm. Further examination remarked an ecchymotic appearance of the stomach portion entrapped in the hernia defect suggesting recent strangulation of the stomach. The lungs showed atelectasis with signs of pulmonary infection in the histology study.
Conclusions: CDH might be considered uncommon and not always mentioned in the list of sudden death in infant causes. Forensic pathologists should know of this malformation in order to apply the best autopsy techniques and thus allow positive feedback to pediatricians considering the possible legal implications.
Competing Interests: Competing of interestsThe authors declare that they have no competing interests.
(© The Author(s) 2022.)
Databáze: MEDLINE
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