Link: https://www.ncbi.nlm.nih.gov/pubmed/30799220

J Obstet Gynaecol Can. 2019 Feb 22. pii: S1701-2163(19)30001-5. doi: 10.1016/j.jogc.2018.12.024. [Epub ahead of print]
Strangulated Congenital Diaphragmatic Hernia of Bochdalek Diagnosed in Late Pregnancy: A Case Report and Review of the Literature.
Ménassa M1, Bergeron AM2, Drolet S1, Bouchard A3.
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Abstract
BACKGROUND:
Congenital diaphragmatic hernia is an unusual condition in the adult population because it is mostly a neonatal diagnosis. This entity may be triggered by pregnancy and threaten the life of the mother and her fetus.

CASE:
This report presents the case of a maternal diaphragmatic hernia diagnosed at 35 weeks of pregnancy with epigastric pain, nausea, and vomiting. Patient developed respiratory distress, and a radiograph revealed left lung collapse. A chest tube was inserted for a presumed tension pneumothorax. The patient's condition deteriorated, and a diaphragmatic hernia containing the stomach, transverse colon, and small bowel was diagnosed. The patient underwent laparotomy with Caesarean section, hernia reduction, and diaphragmatic repair.

CONCLUSION:
A high degree of suspicion is required to avoid misdiagnosis and management delay. Surgical treatment must be individualized according to gestational age and clinical setting.

Copyright © 2019 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

KEYWORDS:
Bochdalek; Diaphragmatic hernia; abdominal repair; complication of pregnancy

PMID: 30799220 DOI: 10.1016/j.jogc.2018.12.024