A rare case of diaphragmatic hernia combined with extralobar pulmonary sequestration: a case report

BACKGROUND: According to the literature, the combination of extralobar sequestration with diaphragmatic hernia is observed in 12–16% of patients with pulmonary sequestration. The authors present a clinical case of these two pathologies combined. None of the congenital defects was diagnosed in the prenatal period. A pulmonary sequester with an atypical blood vessel was revealed intraoperatively. CLINICAL CASE DESCRIPTION: А diaphragmatic hernia was diagnosed at the first hours after the birth because the newborn baby developed respiratory failure and needed resuscitation measures. An overview X-ray image of the chest organs revealed a left-sided false diaphragmatic hernia. Surgical intervention thoracoscopy was performed on the 2nd day of newborn’s life. During the surgery additional malformation was revealed. The pulmonary sequestration was noted after the organs were immersed into the abdominal cavity. Surgical manipulations — removal of pulmonary sequestration and plastic defect of the diaphragm — was successful. CONCLUSION: It is very important to increase the professional attention of pediatric specialists — neonatologists, pediatricians, intensive care specialists, pediatric surgeons, specialists of antenatal ultrasound diagnostics — not only to the problem of pulmonary sequestration, but also to the problem of congenital malformations of the chest organs in general.