Ahmed Nabil Abdelhadi,Khaled Zamel Aldaraan,Mohamed Hany Hassab,Muhammad Elsayed Abdelhafez Mahmoud,
Dual Chest Pathology Presenting with Acute Respiratory Failure: A Case Report and Review of Literature
American Journal of Surgical Case Reports
2020
2674-5046
http://dx.doi.org/10.31487/j.AJSCR.2020.01.09
https://www.sciencerepository.org/dual-chest-pathology-presenting-with-acute-respiratory-failure_AJSCR-2020-1-109 
Abstract: Congenital diaphragmatic hernia (CDH) is an uncommon neonatal pediatric surgical problem. About 5-25%
of cases had delayed presentation, making diagnostic challenge and requiring a high index of suspicion.
Combination of diaphragmatic hernia and severe pneumonia with rapid deterioration of the case up to
respiratory failure is a rare occasion. Herein, we present a case of 2-years-old female referred to our hospital
intubated, ventilated due to type 2 respiratory failure resulting from dual chest pathology (severe pneumonia
and left sided congenital diaphragmatic hernia). She was admitted at the pediatric intensive care unit (PICU),
stabilized then operated for repair of her diaphragmatic hernia. Post-operatively, she remained intubated,
ventilated for 7 days then weaned gradually from the ventilator. The cardiorespiratory status has much
improved and she started oral feeding by the 8th post-operative day and discharged home in a stable
condition.
Keywords: Congenital diaphragmatic hernia, delayed presentation, pneumonia, hernia repair, septic shock, respiratory failure