A rare case of diaphragmatic hernia combined with extralobar pulmonary sequestration: a case report

BACKGROUND: According to the literature, the combination of extralobar sequestration with diaphragmatic hernia is observed in 12–16% of patients with pulmonary sequestration. The authors present a clinical case of these two pathologies combined. None of the congenital defects was diagnosed in the prenatal period. A pulmonary sequester with an atypical blood vessel was revealed intraoperatively.

CLINICAL CASE DESCRIPTION: А diaphragmatic hernia was diagnosed at the first hours after the birth because the newborn baby developed respiratory failure and needed resuscitation measures. An overview X-ray image of the chest organs revealed a left-sided false diaphragmatic hernia. Surgical intervention thoracoscopy was performed on the 2^nd day of newborn’s life. During the surgery additional malformation was revealed. The pulmonary sequestration was noted after the organs were immersed into the abdominal cavity. Surgical manipulations — removal of pulmonary sequestration and plastic defect of the diaphragm — was successful.

CONCLUSION: It is very important to increase the professional attention of pediatric specialists — neonatologists, pediatricians, intensive care specialists, pediatric surgeons, specialists of antenatal ultrasound diagnostics — not only to the problem of pulmonary sequestration, but also to the problem of congenital malformations of the chest organs in general.