CC-BY 4.0 · European J Pediatr Surg Rep 2017; 05(01): e51-e54
DOI: 10.1055/s-0037-1606288
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Intestinal Perforation during the Stabilization Period in a Preterm Infant with Congenital Diaphragmatic Hernia

Zbyněk Straňák
Third Faculty of Medicine, Charles University, Prague, Czech Republic
Fetal Medicine Centre, Institute for the Care of Mother and Child, Prague, Czech Republic
,
Karel Pýcha
Department of Pediatric Surgery, Second Faculty of Medicine, Charles University, Prague, Czech Republic
,
Simona Feyereislova
Third Faculty of Medicine, Charles University, Prague, Czech Republic
Fetal Medicine Centre, Institute for the Care of Mother and Child, Prague, Czech Republic
,
Jaroslav Feyereisl
Fetal Medicine Centre, Institute for the Care of Mother and Child, Prague, Czech Republic
,
Michal Rygl
Department of Pediatric Surgery, Second Faculty of Medicine, Charles University, Prague, Czech Republic
› Author Affiliations
Further Information

Publication History

08 September 2016

21 July 2017

Publication Date:
31 August 2017 (online)

Abstract

Background Delayed surgery after stabilization of infants with congenital diaphragmatic hernia (CDH) is an accepted strategy. However, the evidence favoring delayed versus immediate surgical repair is limited. We present an extremely rare case of a very low-birth-weight infant with prenatally diagnosed left-sided CDH and unexpected transmural bowel perforations developing within the postnatal stabilization period.

Case Report A neonate born at 31st week of gestation with a birth weight of 1,470 g with antenatally diagnosed left-sided CDH presented with bowel dilation leading to transmural bowel perforations on the 2nd day of life. Meconium pleuroperitonitis resulted in severe systemic inflammatory response syndrome, pulmonary hypertension, multiple organ failure, and death.

Conclusion In neonates with CDH deteriorating under standard postnatal management, intestinal perforation, and early surgical intervention should be considered.