Peri Operative Management of a Simultaneously Symptomatic Diaphragmatic Hernia and Imperforate Anus in a Neonate: A Rare but Challenging Combination

Congenital diaphragmatic hernia a rare congenital malformation which often requires surgical interventions. The surgery is not an emergency, and it can be done within days with planned preoperative optimisation. We present a case of a premature neonate presented with co-existence of left side diaphragmatic hernia with imperforate anus. Presence of imperforate anus prevents the passage of meconium leading to distention of bowel increasing the resistance inside the left hemithorax. Therefore, an urgent repair of the diaphragmatic hernia with colostomy formation was done under general anaesthesia after 48 hours of birth. Patient was managed in a paediatric intensive care unit both pre and post operative period. Even though the post operative period was complicated with a broncopneumonia and a pleural effusion, he was discharged from ICU 20 days after the procedure.