Congenital diaphragmatic hernia

Deborah A. Reid, RTR RDMS

Sonographer, Maternal Fetal Center
Texas Children's Hospital Pavilion for Women

Case report:

32-year-old patient (G4P1A2) with diabetes mellitus which is well-controlled by an Insulin Pump (BMI 42) and macrosomia for previous pregnancy was referred to our institution for a congenital diaphragmatic hernia which was evaluated for possible fetal intervention.

Patient underwent amniocentesis which came back as 46 XX.

Ultrasound showed left-sided congenital diaphragmatic hernia with mild polyhydramnios.

The left-sided congenital diaphragmatic hernia contained a large portion of the bowel, spleen, stomach and the tip of the left lobe of the liver. In addition to the congenital diaphragmatic hernia, a sub-diaphragmatic sequestration was also noted which was confirmed by MRI.

The patient did not qualify for fetal intervention due to her BMI exceeding the limits.

Figure 1-10: The left-sided congenital diaphragmatic hernia contained a large portion of the bowel, spleen, stomach and the tip of the left lobe of the liver

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Figure 11: MRI confirmed the diagnosis

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