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An intriguing case of post-operative respiratory failure from an occult diaphragmatic hernia- be aware of the masquerader


1 Department of Cardiac Anaesthesia, Artemis Hospital, Sector 51, Gurugram, Haryana, India
2 Department of Paediatric Cardiology, Artemis Hospital, Sector 51, Gurugram, Haryana, India
3 Department of Paediatric Cardiology and Cardiac Surgery, Artemis Hospital, Sector 51, Gurugram, Haryana, India

Correspondence Address:
Biplob Borthakur
Department of Cardiac Anaesthesia, Artemis Hospital, Sector 51, Gurugram, Haryana - 122 011
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_227_18

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Year : 2020  |  Volume : 23  |  Issue : 2  |  Page : 237-240

 

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Though respiratory complications after cardiac surgery for congenital heart disease are common, and malformations of the diaphragm can be expected in these patients, the presence of an occult diaphragmatic defect unrecognisible preoperatively and complicating the post operative course is very rare and need a high index of suspicion for diagnosis in the setting of post operative respiratory failure. We present here a case of post operative respiratory failure from a delayed presenting diaphragmatic hernia in a 2-month-old boy who underwent corrective surgery for Taussig bing anomaly and hypoplastic aortic arch. Surgical repair of the diaphragmatic defect and reduction of the bowel loops to the abdomen resulted in rapid weaning from ventilation and recovery with subsequent discharge from hospital.






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1 Department of Cardiac Anaesthesia, Artemis Hospital, Sector 51, Gurugram, Haryana, India
2 Department of Paediatric Cardiology, Artemis Hospital, Sector 51, Gurugram, Haryana, India
3 Department of Paediatric Cardiology and Cardiac Surgery, Artemis Hospital, Sector 51, Gurugram, Haryana, India

Correspondence Address:
Biplob Borthakur
Department of Cardiac Anaesthesia, Artemis Hospital, Sector 51, Gurugram, Haryana - 122 011
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_227_18

Rights and Permissions

Though respiratory complications after cardiac surgery for congenital heart disease are common, and malformations of the diaphragm can be expected in these patients, the presence of an occult diaphragmatic defect unrecognisible preoperatively and complicating the post operative course is very rare and need a high index of suspicion for diagnosis in the setting of post operative respiratory failure. We present here a case of post operative respiratory failure from a delayed presenting diaphragmatic hernia in a 2-month-old boy who underwent corrective surgery for Taussig bing anomaly and hypoplastic aortic arch. Surgical repair of the diaphragmatic defect and reduction of the bowel loops to the abdomen resulted in rapid weaning from ventilation and recovery with subsequent discharge from hospital.






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