Congenital diaphragmatic hernia in limited fascilitation : a case report

friska supriyanto1, alfonso anggriawan1, ria c tahun2

1)

Department Of Child Health,Soe Hospital,Timor Tengah Selatan. 2)Head of Hospital,Soe

Hospital,Timor Tengah Selatan.

Abstract
Background:The prevalence of congenital diaphragmatic hernia is 1:2000-3000 live births.
About 80% are left-sided and a small percentage may be bilateral.The etiology is unknown. CDH
might occur as a part of a syndromic genopathy or isolated. About 40% of the patients have
associated major congenital anomalies and also have poorer outcome than the isolated one. In
poor medical settings institution,the lack of proper diagnostic laboratory and therapeutic facilities
are major constraints in managing the respiratory problems.
Objective:To report a case of congenital diphragmatic hernia in a limited facilitation.
Case:A girl infant was referred to the hospital 2days after birth, Apgar score 9-10, 3200grams
birth weight, 1st child of the family. She was born from 25years old mother with 43weeks of
mothers gestational age. Three hours after birth the baby developed tachypnea and cyanosis.
When she arrived at the hospital, she was tachypnea,cyanosis,and grunting. Heart rate 130
times/minute, respiratory rate 90 times/minute. There were subcostal and intercostal retraction,
low respiratory sound of the left thorax, and the heart sound was heard at the right side
(dextrocardia). The baby was resuscitated with saturation checked, the saturation before
resuscitation was 60%. Baby X-ray was done and the results showed herniation of the left
diaphragm and bowel loops into the left thorax with shifting of mediastinal structures including
heart to the right side. Her family took her home because of poor economic status and denied to
do more treatment so we didnt do more laboratory and radiology examination to look for
another possibly anomalies.
Keywords : congenital diaphragmatic hernia, limited fascilitation