medigraphic.com
ISSN 0016-3813 (Print)

2004, Number 2

<< Back Next >>

Gac Med Mex 2004; 140 (2)

Intrathoracic Kidney in a Newborn with Breathing Difficulty Syndrome Secondary to Congenital Diaphragmatic Hernia.

Urdaneta-Carruyo E, Méndez-Parra A, Palencia-Molina MA, Urdaneta-Contreras A, Urdaneta-Morales A

Language: Spanish
References: 24
Page: 219-224
PDF size: 1055.10 Kb.


ABSTRACT

Congenital diaphragmatic hernia (CDH) is found frequently in from 0.17 to 0.57 among 1000 newborns and is associated with intrathoracic kidney (IK) in 0.25%. The objective of the present work was to describe both present pathologies in a newborn and to review the literature in this respect. Clinical case: male newborns, who presented tachypnea sudden and persistent for the first 24 h of life. For the that was physical exam, we included breathing difficulty (eight points of Silverman’s) and cyanosis; initial arterial gases: hypoxemia and hypocapnia (acute respiratory failure type I); thorax X-ray; increase of bronchial plot and of parahiliary density; normal lungs, pleuro-peritoneal membrane and solid mass superimposed on heart silhouette were observed and confirmed by echocardiogram. Computed axial tomography (CAT) revealed left kidney and part of spleen inside thorax, beside inferior lobe of left lung. Immediately, the patient was mechanically ventilated and after 2 days, was operated sourgically for correction of CDH and descent of left kidney. After surgical intervention, initial syntomatology disappeared and evolution was satisfactory. The present case illustrates how the kidney on occasion can emigrate due to congenital default to the thorax of the wall of the diaphragm and be a casual discovery at the moment of radiologic exploration.


REFERENCES

  1. Bochdalek V. Einige betrachtungen ueber die einstllung des angeborenen zwerchfellbruches als beitrag zur pathologischen anatomie der hernien. Viertelijahrs Prakt Heik 1848;19:89-97.

  2. Thibeault D, Haney B. Lung volume, pulmonary vasculature, and factors affecting survival in congenital diaphramatic hernia. Pediatrics 1998;101:289-295.

  3. George D, Cooney T, Chiu B, Thurlbeck W. Hypoplasia and immaturity of the terminal lung unit (cinus) in congenital diaphragmatic hernia. Am Rev Resp Dis 1987;136:947-950.

  4. Hallisey M, Caride. Single perfusion defect secondary to intrathoracic kidney. Clin Nucl Med 1990;15:523-524.

  5. Philip N, Gambarelli D, Guys J, Camboulives J, Ayme S. Epidemiological study of congenital diapharamatic defects with special reference to aetiology. Eur J Pediatr 1991;150(10):726-7729.

  6. Sadler T. Body cavities and serous membranes. In: Sadler T. ed. Langman’s medial embiology. 6th ed. Baltimore, MS, USA: Williams & Wilkins; 1990. p. 164-78.

  7. Losty P, Vanamo K, Rintala R, Donahoe P. Schnitzer J, Lloyd D. Congenital diaphramactic hernia - does the side of the defect influence the incidence of associated malformations? J Pediatr Surg 1998;33(3):507-510.

  8. Bass T, Wharton K, Cicero M, Kelly R, Dory C. Radiological case of the month. Arch Pediatr Adolesc Med 1996;150:425-428.

  9. Franciskovic V, Martincic N. Intrathoracic kidney. Br J Urol 1959;31:156.

  10. Summer T, Volberg F, Smolen P. Intrathoracic kidney diagnosis by ultrasound. Ped Radiol 1982;12:78.

  11. Donat M, Donat P. Intratoracic kidney: a case report with a review of the world literature. J Urol 1988;140:131-133.

  12. Ramus A, Slovis T, Reed J. Intrathoracic kdney. Urology 1979;13:14-19.

  13. Ho H, Liaw S, Chang P. Delayed manifestation of congenital diaphramatic hernia with intratoracic kidney: report of one case. Acta Paed Sin 1997;38(1):61-4.

  14. Campbell M. Renal ectopy. J Urol 1939;24:187-189.

  15. Saucedo B, Castillo C, López U, Martínez R. Riñón Intratorácico. Comunicación de dos casos y revisión en la literatura. Rev Mex Urol 1997;57(6):254-258.

  16. Baurys W, Servoss S. Eventration of the diaphragm: report of a case involving the kidney. Urol Cutan Rev 1949;53:535.

  17. Spillane R, Prather G. Right diaphragmatic eventration with renal displacement; case report. J Urol 1952;68:804.

  18. Fleischner F, Robins S, Abrahams M. Renal ectopia and congenital diaphramatic hernia. Radiology 1950;55:24.

  19. Bugden W. Two cases of intra-thoracic kidney. Dis Chest 1950;17:537.

  20. Hallisey M, Caride V. Single perfusion defect secondary to intrathoracic kidney. Clin Nucl Med 1990;15:523-524.

  21. Kubricht W, Henderson J, Bundrick S, Veneble D, Eastham J. Renal cell carcinoma in an Intrathoracic kidney: radiographic finding and surgical consideration. South Med J 1999;92(6):628-629.

  22. Matzo B, Balance K, Cockle A, Piero A, Rodeck C. Prenatal diagnosis of an ectopic intrathoracic kidney in right-sided congenital diaphragmatic hernia using color Doppler ultrasonography. Ultrasonund Obstet Gynecol 2001;18(2):173-174.

  23. Blank GC, Melman SE, Beltrán BF, Frontana RP, Catalán LJ, Bierzwinski KA. Nuevos conceptos de terapia neonatal en el manejo de hernia diafragmática congénita. Acta Pediatr Mex 2002;23(6):363-368.

  24. Hazebroek FWJ, Tibboel D, Bos AP, Pattenier AW, Madern GC, Bergmeijer JH, Molenaar JC. Congenital diaphragmatic hernia: impact of preoperatorie stabilization. A prospective pilot study in 13 patients. J Pediatr Surg 1988;23:1139-1146.




2020     |     www.medigraphic.com