Abstract
Three cases of atypical congenital diaphragmatic hernia including an extremely rare case of multiple diaphragmatic hernia were reported. Case 1 was a 10-month-old boy who showed two round densities at the base of the left hemithorax on preoperative chest roentgenography, CT, and MRI before the radical repair of imperforate anus. Laparotomy for closure of colostomy revealed two protrusions of the diaphragm into the left hemithorax (3.5 cm and 4 cm in diameter, respectively), which contained part of the left lobe of the liver and part of the spleen each. Both diaphragmatic defects were closed. Histological examination of the biopsied hernial sac revealed a scarcity of muscle fibers. Case 2 was an 11-month-old boy in whom mass was detected at the base of the right hemithorax before the radical surgery for Hirschsprung's disease. This lesion was not present in the neonatal period. Thoracotomy revealed a protrusion of the liver through a defect 3-cm diameter located at the center of the diaphragm. The liver tissue was excised and the defect was closed. Case 3 was a 25-day-old boy under treatment for sepsis at NICU, in whom a roud mass was detected incidentally at the top of the right hemidiaphragm. Laparotomy revealed bulging of the right lobe of the liver into the hemithorax with a hernial sac of 3 cm in diameter. The defect was closed. All three patients did well after surgery. The characteristics of this type of congenital diaphragmatic hernia were discussed.
