Left Portal Hypertension and Hypersplenism in a Child With Congenital Diaphragmatic Hernia: A Rare Case Report.

Abstract

Background: T Congenital diaphragmatic hernia (Bochdalek hernia), which occurs in 1/2,200 live births, is typically diagnosed in the prenatal or immediate postnatal period. Diaphragmatic hernia is rare in older children and adults and can be presented with acute respiratory failure, incarcerated hernia, acute pancreatitis, or rare conditions such as left portal hypertension and hypersplenism.

Objective: The aim of this case report was to present 15-year-old male with vomiting and mild upper abdominal pain who had mild epigastric tenderness with no guard and an IV grade splenomegaly caused by Congenital Diaphragmatic Hernia. Case presentation: We report a case of left portal hypertension and hypersplenism in an adolescent with congenital diaphragmatic hernia. Typical clinical presentations include abdominal pain, respiratory symptoms, or intestinal obstruction in incarcerated diaphragmatic hernia. Additionally, some uncommon symptoms reported in literature include gastrointestinal bleeding as a result of portal hypertension, thrombocytopenia due to hypersplenism, and acute pancreatitis.

Conclusion: The treatment has released the obstruction in the splenic vein and reduce returned collateral gastric blood flow. Splenectomy should be considered based on many factors, such as anatomic anomalies or the degree of hypersplenism and portal hypertension. This is a rare clinical entity with only a few cases that have been reported in the literature.