Congenital intrapericardial hernia in a 12-year-old child: clinical presentation, diagnosis and treatment
Bulgarian Medical Journal, 2024, 18(4), 51-54.
L. Taneva1, N. Kartulev1, Z. Antonova1, N. Tolekova1, V. Oparanova1, Y. Pahnev1, E. Rangelov1, V. Strahinova2, B. Mladenov3, A. Dasheva-Dimitrova4, N. Gabrovska5, H. Shivachev1
1 Pediatric Surgery Department, UMHATEM “N. I. Pirogov“ ‒ Sofia
2 Radiology Department, UMHATEM “N. I. Pirogov“ ‒ Sofia
3 Pediatric Anesthesiology and Intensive Care Department, UMHATEM “N. I. Pirogov“ ‒ Sofia
4 Clinic of Pediatric Rheumatology, Pediatric Hospital “Prof. Ivan Mitev” ‒ Sofia
5 Clinic of Pediatric Pulmonology, Pediatric Hospital “Prof. Ivan Mitev” ‒ Sofia
Abstract. The aim of this article is to present a case report of a patient with a very rare congenital intrapericardial diaphragmatic hernia (IPCDH), which can be asymptomatic as well as clinically manifesting. Often, it occurs in association with other congenital anomalies. Presentation of case: In this case report, we present a 12-year-old patient with a congenital diaphragmatic hernia diagnosed radiographically. A computed axial tomography scan was performed to confirm the diagnosis, which revealed intraabdominal herniation in the anterior mediastinum. The subsequent laparoscopy verified an intrapericardial diaphragmatic hernia. The diaphragmatic defect was repaired. The postoperative period was uneventful. At the follow-up of the patient after 3 months, no complaints were reported. Conclusion: Intrapericardial diaphragmatic hernia is a very rare congenital anomaly. The diagnosis is made prenatally in the majority of patients. However, it is possible to be diagnosed after birth or as an incidental finding on pulmonography due to different complaints. Treatment is surgical and in the majority of cases results in permanent correction of the abnormality and good prognosis and survival of patients thereafter.
Key words: congenital intrapericardial diaphragmatic hernia, laparoscopy
Address for correspondence: Lora Taneva, MD, e-mail: tanevaloraognyanova@gmail.com