Bochdalek's Hernia in the Newborn : 6 years' experience

最近6年間に経験したボーダレック孔ヘルニア症例の検討

Yokoyama Takashi

Ichikawa Toru

Hiyama Eiso

Okita Mitsuaki

Miyoshi Nobukazu

Hiroshima Journal of Medical Sciences

[PISSN] 0018-2052

[EISSN] 2433-7668

[NCID] AA00664312

We treated 13 cases of neonatal Bochdalek's hernia at the 1st Department of Surgery, Hiroshima University Hospital in the 6 years from 1978 to 1983 and have studied on the factors responsible for mortality of neonatal Bochdalek's hernia.

The following conclusions were obtained in this study.
1. Of the 13 patients, 7 survived and 6 died. The most frequent cause of death was persistent fetal circulation, the cause of 5 of the deaths.
2. All 3 of the premature newborns died.
3. The earlier the time of onset of symptoms, the higher was the mortality.
4. Five of the 7 patients who required respiratory control by intubation before hospitalization died.
5. The mortality rate for patients with pH less than 7.00, base excess less than－15 mEq/liter, and M index higher than 6 on admission was extremely high.
6. Three of the 7 patients persisting a distinct pressure difference on simultaneous measurement of preductal PaO2 and postductal PaO2 died. In the surviving patients, it was possible to maintain the postductal PaO2 at above 60 mmHg.
7. Trazoline was used on 2 patients, and both died. A thorough study of the time and mode of administration is considered to be necessary.

Bochdalek's hernia

Persistent fetal circulation

Medical sciences [ 490 ]

eng

Hiroshima University School of Medicine

[ISSN] 0018-2052

[NCID] AA00664312

[PMID] 6534927