Right-Sided Congenital Diaphragmatic Hernia With Gut Malrotation: A Rare Case Report

Cureus. 2024 Jul 28;16(7):e65602. doi: 10.7759/cureus.65602. eCollection 2024 Jul.

Abstract

Congenital diaphragmatic hernia (CDH) is a rare surgical cause of respiratory distress in neonates. CDH is caused by the protrusion of the abdominal contents into the thoracic cavity due to the failure of the pleuroperitoneal canal to close by eight weeks of gestation. We present the case of a full-term, female child, weighing 2.85 kg at birth, born by normal vaginal delivery to a 21-year-old primigravida admitted at our level III neonatal intensive care unit (NICU). Antenatal obstetric ultrasonography suggested duodenal atresia. After birth, the child was found to have right-sided CDH with gut malrotation. Intraoperative laparotomy revealed a right Bochdalek posterolateral defect with herniation of small bowel loops and a portion of the right lobe of the liver into the chest cavity and minimally malrotated cecum in the right iliac fossa (RIF). This case highlights the critical need for early detection and multidisciplinary management of congenital anomalies. Effective management requires a multidisciplinary approach, including prenatal counseling, careful surgical intervention, and intensive neonatal care to optimize respiratory and cardiovascular outcomes for affected infants.

Keywords: bochdalek's hernia; cdh; congential diaphragmatic hernia; duodenal atresia; exploratory laparotomy; pulmonary hypertension; pulmonary hypoplasia.

Publication types

  • Case Reports