11.FC.936_CI_Diagnostic et la prise en charge d’une hernie diaphragmatique congénitale
DOI:
https://doi.org/10.55715/jaim.v18i4.1033Keywords:
Congenital diaphragmatic hernia, diagnosis, imaging.Abstract
Congenital diaphragmatic hernia (CDH) is a congenital embryopathy defined by the absence of development of all or part of a diaphragmatic dome. It is a rare condition. Its prevalence has been reported at 2.3 per 10.000 births. It can be discovered prenatally during prenatal ultrasound or fetal MRI. In the postnatal period, diagnosis may be early in the newborn or late in the infant or child. Imaging plays a crucial role in the management of this condition. As first-line examinations, chest X-ray and thoraco-abdominal ultrasound contribute to the diagnosis. The prognosis depends primarily on associated pathologies. We report a case of early postnatal diagnosis of congenital heart disease. This was a female newborn presenting with respiratory distress on day 2 of life. Chest X-ray and thoracoabdominal ultrasound revealed the presence of intestinal loops and liver in the right thorax. The newborn underwent surgery on day 4 of life. A right-sided Bochdalek-type hepatic edema and right lung hypoplasia were confirmed intraoperatively. The postoperative course was uneventful. Our objective was to highlight the role of imaging in the management of this condition.
RÉSUME
La hernie diaphragmatique congénitale (HDC) est une embryopathie congénitale qui se définit par l’absence de développement de tout ou d’une partie d’une coupole diaphragmatique. C’est une pathologie rare. Sa prévalence a été rapportée à 2,3 pour 10.000 naissances. Sa découverte peut être anténatale lors d’échographie prénatale ou d’IRM fœtale. En postnatal, le diagnostic peut être précoce chez le nouveau-né ou tardif chez le nourrisson ou l’enfant. L’imagerie joue un rôle primordial dans la prise en charge de cette pathologie. Examens de première intention, la radiographie et l’échographie thoraco-abdominales contribuent au diagnostic. Le pronostic dépend essentiellement des pathologies associées. Nous rapportons un cas d’HDC de découverte postnatale précoce. Il s’agissait d’un nouveau-né de sexe féminin, présentant une détresse respiratoire à J2 de vie. La radiographie et l’échographie thoraco-abdominale ont mis en évidence la présence d’anses intestinales et du foie dans le thorax droit. Le nouveau-né a été opéré à J4 de vie. Une HDC droite de type Bochdalek et une hypoplasie du poumon droit ont été confirmées en per opératoire. Les suites post opératoires ont été simples. Notre objectif était de souligner le rôle de l’imagerie dans la prise en charge de cette pathologie.
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