Page 290 - Abstract Book KONIKA 18

Neonatology

P-NEO-009
Congenital Diaphragmatic Hernia with Midgut Volvulus: A Case Report

Angelica, Rocky Wilar, Johnny Rompis, Shekina Rondonuwu
Department of Child Health, Sam Ratulangi Medical School/Prof. Dr. R. D. Kandou Hospital,
Manado, North Sulawesi, Indonesia
Abstract
Background Congenital Diaphragmatic Hernia (CDH) is characterized by a defect in the diaphragm leading
to the protrusion of abdominal contents into the thoracic cavity affecting the normal development of the
lungs. Some patients with a CDH also present with acute gastrointestinal problems. Intestinal malrotation,
with incidence percentages 42 - 60%, is relatively common in these neonates due to abnormal rotation
of the embryological midgut. Objective To report a case of a newborn with CHD and midgut volvulus.
Case A male neonate delivered from a 26-year-old mother G1P0A0 at 39-40 weeks of gestational age, weights
of 3,000 gr and 46 cm long. On chest examination, found asymmetrical breathing movement, subcostal and
intercostal retractions with decreased bronchovesicular breathing sound and peristaltisc sounds on the left
chest. X-Ray showed air-filled bowel loops on the left chest. Laparotomy was perfomed and found a 25-
cm defect on the left diaphragma with hernia consisted of tranversum colon, gaster, left lobe of liver, and
midgut volvulus that treated with Ladd’s procedure. After operation, the patient was treated i with ventilator,
antibiotics, total parenteral nutrition, enteral feeding started after 4 days of operation and discharged 19 days
later. Conclusion CDH sometimes presents with acute gastrointestinal problems. The best known is intestinal
malrotation due to abnormal rotation of the embryological midgut.

Keywords: diaphragmatic; hernia; intestinal; volvulus

242 KONIKA XVIII Abstract Book