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Indian Journal of Anesthesia and Analgesia 10(4):p 189-191, October-December 2023. | DOI: https://doi.org/10.21088/ijaa.2349.8471.10423.6
Case Report
Diaphragmatic Hernia in a Parturient: A Case Report
Ravi Madhusudhana, S.P. Shruthi, Kiran N.
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Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Indian Journal of Anesthesia and Analgesia 10(4):p 189-191, October-December 2023. | DOI: https://doi.org/10.21088/ijaa.2349.8471.10423.6
How Cite This Article:
Shruthi SP, Ravi M, Kiran N. Diaphragmatic Hernia in a Parturient: A Case Report. Indian J Anesth Analg. 2023;10(4):189–91Timeline
Received : August 10, 2023
Accepted : October 03, 2023
Published : October 30, 2023
Abstract
Introduction: Diaphragmatic hernia is a condition in which abdominal contents enter the thoracic cavity through an abnormal opening in the diaphragm. Though diaphragmatic hernia in pregnancy is a rare occurrence it imposes challenges in terms of mode and time of delivery along with repair of hernia.
Case Report: A 34-year female G2 P1 L1 with 37 weeks 4 days gestational age presented in latent labour. Patient had undergone an Emergency LSCS with B/L Tubectomy under General Anaesthesia anda live male baby of birth weight 3.74 kgs was delivered. After extubation the patient had one episode of drop in saturation and oxygen supplementation was started immediately and patient was shifted to icu for observation.
A chest x-ray was done which showed bowel loops in the thoracic cavity. Later an HRCT was done confirming large defects of 5 x 7 cm of stomach, small bowel loops, large bowel loops and mesentery herniating into the left hemithorax with mild mediastinal shift to right and complete collapse of left lung suggesting diaphragmatic hernia. There was no evidence of a gastric volvulus or bowel ischemia.
Patient gives history of abdominal pain radiating to back and thigh along with fever and dry cough since 2 days. No history of chest pain, breathlessness, palpitations, epigastric pain, nausea, vomiting, headache, blurring of vision or burning micturition. No significant past or family history. General surgery and pulmonology opinion was taken which explained the need for cardio thoracic surgery intervention and the patient was referred to higher centre.
Conclusion: Diaphragmatic hernia complicating pregnancies are rare in occurrence imposing severe complications. Early diagnosis clinically and radiologically should be evaluated in pregnant women having gastrointestinal symptoms not responding to standard treatments.
Key Message: Usually diaphragmatic hernia presents in early childhood and needs surgical intervention. This was a rare presentation in the third trimester of pregnancy with mild gastrointestinal symptoms. In diaphragmatic hernia the most complicating symptom is obstruction which need immediate surgical intervention.
References
- 1. Fleyfel M, Provost N, Ferreira JF, Porte H, Bourzoufi K. Management of diaphragmatic hernia during pregnancy. Anesth Analg. 1998;86:501-3.
- 2. Hernandez-Aragon M, Rodriguez-Lazaro L, Crespo-Esteras R, Ruiz-Campo LA, Calvo et al. Bochdalek Diaphragmatic Hernia Complicating Pregnancy In The Third Trimester: A Case Report. Obstet Gynaecol Case Rep. 2015;2:057.
- 3. Schwenter L, et al. Exacerbation of a maternal hiatus hernia in early pregnancy presenting with symptoms of hyperemesis gravidarum: case report and review of literature. Arch Gynecol Obstet. [Year;Volume:Page numbers Missing.
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This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
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Conflicts of Interest
The authors report no conflicts of interest in this work.
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Cite this article
Shruthi SP, Ravi M, Kiran N. Diaphragmatic Hernia in a Parturient: A Case Report. Indian J Anesth Analg. 2023;10(4):189–91
Licence:
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
| Received | Accepted | Published |
|---|---|---|
| August 10, 2023 | October 03, 2023 | October 30, 2023 |
DOI: https://doi.org/10.21088/ijaa.2349.8471.10423.6
Keywords
Diaphragmatic HerniaMedical and Surgical Complications of PregnancyConservative and Surgical RepairsSearch for Similar Articles
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Timeline
| Received | August 10, 2023 |
| Accepted | October 03, 2023 |
| Published | October 30, 2023 |
licence
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
