IMAGES IN EMERGENCY MEDICINE
Late-diagnosed diaphragmatic hernia in an 8-year-old girl
Sheffield Children’s NHS Foundation Trust, Sheffield, UK
Correspondence to:
Dr A R Hart, Sheffield Children’s Hospital, Western Bank, Sheffield S10 2TH, UK; t.hart@doctors.org.uk
Accepted 14 March 2008
| The first 150 words of the full text of this article appear below. |
An 8-year-old girl presented to the emergency department with left-sided flank pain. Her abdomen examination was normal, but she was pale, dehydrated, tachycardic (116 beats per minute) and tachypnoeic (28 breaths per minute). Her right hemithorax was hyperexpanded. Over the left hemithorax she had decreased air entry, hyperresonant percussion and increased vocal resonance. Chest x ray revealed a left-sided Bochdalek diaphragmatic hernia (fig 1). Placement of a nasogastric tube relieved her symptoms and the diagnosis was confirmed at surgery the next day. The colon, stomach and spleen were within the thorax and the spleen was considerably bigger than the hernial orifice.
Figure 1 Chest x ray showing left-sided diaphragmatic hernia.
| |||||||||
Presentation of Bochdalek herniae outside the neonatal period is rare.1 Our case demonstrates that abdominal organs can remain within the hemithorax for prolonged periods without causing symptoms. This case reminds emergency physicians to consider the diagnosis to prevent incorrect, possibly
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
