Ahmad Khan Choudary, Fahim Anwar.
Right Sided Congenital Diaphragmatic Hernia.
J Surg Jan ;23-24:53-4.

Congenital Diaphragmatic Hernia is a dilemma for both the parents and the pediatric surgeon because it carries high mortality especially in the patients who are symptomatic at birth. In general, latter the onset of symptoms, better is the prognosis. Postoperative survival figures close to 100% have been recorded for infants who were not brought for operation until after the first 24 - 48 hours.

A three and a half years old boy was admitted with the history of vomiting since birth, failure to gain weight and recurrent attacks of upper respiratory tract infection. His biochemical investigations were within normal limits. X-ray chest showed a soft tissue density in the chest with an absent normal liver shadow in the right upper abdomen. Barium studies were carried out and it showed Rolling Hiatus Hernia with stomach on the right side. Patient was prepared for surgery. Abdomen was opened through upper transverse incision. Liver was mobilizes by dividing left triangular ligament. A defect of 50 cm was found in the right curs of the diaphragm near the hiatal region through which stomach, transverse colon and the small intestine were herniating into the right chest. Herniated contents reduced by gentle pulling of small intestine first, transverse colon and then stomach. The defect was close with prolene suture along with few anchoring stitches to the stomach and crus of diaphragm. Abdomen was closed in layers with subcuticular vicryl suture of skin. Postoperative recovery was smooth.

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