Case Report - Anesthetic Challenges of Congenital Diaphragmatic Hernia Repair in an Adult

Smriti Sinha, Varghese Zachariah K

Abstract: Congenital diaphragmatic hernia (CDH) usually presents in the neonatal period with respiratory distress. The presentation in adults varies from asymptomatic to unexplained symptoms, which makes CDH difficult to diagnose. We report an anaesthetic management of CDH repair in an adult patient, who presented with abdominal pain. CDH was an incidental finding. The patient was planned for laproscopic CDH repair, keeping thoracotomy as alternative. Anaesthetic management was complicated by pulmonary hypoplasia on affected side, pulmonary hypertension and need of one lung ventilation. Postoperatively analgesia was also a challenge to prevent atelectasis.

Keywords: Congenital diaphragmatic hernia, pulmonary hypoplasia, thoracotomy