A newborn presented severe respiratory distress. On examination he was found to have scaphoid abdomen and absent breath sounds on left side of chest. The most likely diagnosis is:
Correct Answer: Congenital Diaphragmatic hernia
Description: Ans: c Congenital Diaphragmatic hernia). (Ref: Radiology Review Manual, 5th ed., 478)CONGENITAL DIAPHRAGMATIC HERNIA# It is most common intrathoracic fetal anomaly due to absence of closure of pleuroperitoneal canal by 9th week of gestation# Congenital diaphragmatic hernia occur in two locations:- Posterolateral pleuroperitoneal canal (Bochdalek hernia)--common- Anteromedial pleuroperitoneal canal (Morgagni hernia)--rare# Left sided (Bochdalek) hernias are much more frequent than right sided.# On USG, congenital diaphragmatic hernia can be detected as early as at 17th week of gestation.# Small intestine in 88%, stomach in 60%, colon in 56%, spleen in 45%, liver in 51% and kidney in 22% chances of herniation into chest in Bochdalek hernia.# Mediastinal deviation is often seen first and is the most obvious USG sign of CDH.# Absolute diagnostic sign is visualization of peristalsis in chest and paradoxical motion of the abdominal contents on fetal inspiration.0# In Morgagni hernia, omentum and colon are the most frequent hernial contents. It is known to be associated with trisomy syndromes.# Presents as respiratory distress in neonatal period due to life threatening deficiency of small airways and alveoli, and scaphoid abdomen.# CXR:- Bowel loops in chest- Contralateral mediastinal shift- Complete/partial absence of diaphragm- Absence of stomach/small bowel in abdomenCongenital cystic adenomatoid lung malformation (CCAM/CALD)# It is congenital cystic abnormality of lung characterized by a interlobar mass of disorganized pulmonary tissue# Presents with respiratory distress and severe cyanosis in first week of life (66%) or within first year of life (90%)# Equal frequency in all lobes seen# Three types are known: microcystic, macrocystic and mixed type.# CXR:- Unilateral expansile mass with well-defined margins (80%)- Multiple air/occasionally fluid-filled- Compression of adjacent lung cysts- Contralateral mediastinal shift (87%)- Hypoplastic ipsilateral lung- Proper position of abdominal viscera- Spontaneous Pneumothorax (late sign)
Category:
Pediatrics
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now