A newborn male child presents with respiratory distress in the neonatal unit. His X-ray shows left hemithorax with multiple air-filled structures and mediastinal shift to the right. Which of the following represents the most likely diagnosis?
Correct Answer: Congenital diaphragmatic hernia
Description: Diaphragmatic hernia in a neonate is evidenced by the presence of bowels in the thorax, characterised by multiple air-filled structures. The pleuro-peritoneal canal is a defect in the diaphragm which allows the contents of the abdomen to enter the thorax. The mediastinal structures are pushed to the opposite side leading to the contralateral mediastinal shift. Hernia is on the left side in 90% of the cases. Poor prognosis depends upon the presence of stomach in the thorax and the degree of hypoplasia of the lungs. Ref: Radiological Imaging of the Neonatal Chest By Veronica B. Donoghue, Per G. Bjornstad, 2007, Pages 157-158 ; Pediatric Radiological Signs, Volume 1 By Michael Grunebaum, Page 283 ; Radiological Imaging of the Neonatal Chest By Veronica B. Donoghue, 2nd Edition, Page 104.
Category:
Radiology
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