Congenital malformation - diaphragmatic eventration in children: clinic, diagnosis and treatment tactics
DOI:
https://doi.org/10.15574/PS.2024.3(84).5157Keywords:
congenital malformation, diaphragmatic eventration, clinical course, diagnosis, therapeutic tactics, childrenAbstract
The first scientific work in Ukraine to describe congenital diaphragmatic eventration (DE) in children.
Aim - to identify a group of children with congenital DE based on a retrospective study; to analyze the clinical course, diagnostic methods and therapeutic tactics in this pathology.
Materials and methods. A retrospective study of medical records of 28 children with congenital DE over the past 30 years who were undergoing inpatient examination and treatment in the clinic of pediatric surgery at the SI «Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova of the NAMS of Ukraine». The following data were analyzed: age, sex, clinical symptoms, diagnostic methods, localization (and magnitude) of the eventration, associated anomalies, and treatment tactics: indications for conservative therapy and surgical correction.
Results. The study included 28 children aged from birth to 14 years, on average 39.1±38.7 months. There were 5 girls and 23 boys, with a ratio of 1:4.6. DE in 53.6% was left-sided, in 46.4% - right-sided. A diagnostic algorithm was created to identify DE, its complications and concomitant pathology. Therapeutic tactics for DE, indications for surgical treatment and dynamic monitoring were developed. Out of 28 children with DE, 18 were operated on.
Conclusions. Congenital DE occurred in children from the period of newborn to 14 years of age, predominantly in boys and was always unilateral. Clinical manifestations of DE were present in 60.7% of cases. Their onset was more frequent at birth or at 1 year of age. Respiratory disorders predominated, and gastrointestinal disorders were less common. The asymptomatic course of the defect was observed in 39.3% of patients. The developed diagnostic algorithm for DE included: X-ray, ultrasound, computed or magnetic resonance imaging and consultations with related specialists. Surgical treatment was indicated for the vast majority of children with DE.
The study was performed in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of all the institutions mentioned in the work. Parental informed consent was obtained for the study.
The authors declare no conflict of interest.
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