In need of a patch UP: Recurrent congenital diaphragmatic hernia presenting with a large pleural effusion

摘要

We report a case of recurrent congenital diaphragmatic hernia (CDH) presenting with a large unilateral pleural effusion. A 12-year old boy who had a left sided CDH repaired in the neonatal period, presented with fever, lethargy, and non-productive cough. Chest radiograph demonstrated a loculated pleural effusion. Computed tomography scan revealed recurrent herniation of abdominal contents. To our knowledge, this is the first reported case of a recurrent congenital diaphragmatic hernia presenting with large pleural effusion. Highlights ? We present an original case of a recurrent congenital diaphragmatic hernia with a very large pleural effusion. ? Review of factors contributing to failure of diaphragmatic hernia repair. ? Early recognition of recurrence is crucial to prevent injury and necrosis of intra-thoracic abdominal contents. ? High index of suspicion for hernia recurrence must be maintained in patients with persistent respiratory or gastrointestinal symptoms.