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Liver Herniation Presenting as Respiratory Distress and Cardiomegaly

Liver Herniation Presenting as Respiratory Distress and Cardiomegaly Abstract Respiratory distress and cardiomegaly in the immediate postnatal period are most frequently due to primary disease of the lungs or the vascular system. Herniation of the liver through the diaphragm into the chest cavity is rare, but can cause respiratory embarrassment and cyanosis.1 Hypoplastic left heart syndrome, coarctation of the aorta, and Ebstein's anomaly of the tricuspid valve all may manifest cardiomegaly and respiratory distress.2 Sepsis,3 hypocalcemia,4 and asphyxia5 have also produced such findings. The following case report is one of congenital liver herniation manifesting respiratory distress and generalized cardiomegaly. Previously reported cases of liver herniation have not mentioned cardiomegaly as an early finding. Report of a Case.—A 6-hour-old boy was admitted because of progressive tachypnea and cyanosis beginning one hour after birth. Vaginal delivery was uneventful, with Apgar scores of 8 and 9 at one and five minutes, respectively. Birth weight was 3,843.8 References 1. Ravitch MM, Handelsman JC: Defects in right diaphragm of infants and children with herniation of liver . Arch Surgery 64:794-802, 1952.Crossref 2. Moss AJ, Adams F: Heart Disease in Infants, Children, and Adolescents . Baltimore, Williams & Wilkins Co, 1977, p 262. 3. Postel J, Schloerb PR: Cardiac depression in bacteremia . Ann Surg 186:74-82, 1977.Crossref 4. Roberton NR, Smith MA: Early neonatal hypocalcemia . Arch Dis Child 50:604-609, 1975.Crossref 5. Rowe RD, Hoffman T: Transient myocardial ischemia of the newborn infant: A form of severe cardiorespiratory distress in full term infants . J Pediatr 79:243-250, 1972.Crossref 6. Bradley JE, Greiner DJ: Diaphragmatic hernia . Am J Dis Child 66:143-148, 1943. 7. Kaufman SA, Madoff IM: Intrathoracic accessory lobe of liver . Ann Intern Med 53:403-407, 1960.Crossref 8. Craighead C, Strug L: Diaphragmatic deficiency in retrocostoxiphoid area . Surgery 44:1062-1069, 1958. 9. Campbell J: The diaphragm in roentgenology of the chest . Rad Clin North Am 1:395-410, 1963. 10. Armstrong RG, Stanford W: Liver scan in the diagnosis of liver hernia . Acad Fam Pract Gen Pract 1:87-89, 1970. 11. Berger RL, Rodriquez-Aquero J, Madoff IM: Herniation of the liver through the foramen of Morgagni . N Engl J Med 276:243-245, 1962.Crossref 12. Vaughn CC: Diagnosis of localized eventration . Dis Chest 54:467-469, 1968.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Liver Herniation Presenting as Respiratory Distress and Cardiomegaly

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Publisher
American Medical Association
Copyright
Copyright © 1980 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1980.02130230069020
Publisher site
See Article on Publisher Site

Abstract

Abstract Respiratory distress and cardiomegaly in the immediate postnatal period are most frequently due to primary disease of the lungs or the vascular system. Herniation of the liver through the diaphragm into the chest cavity is rare, but can cause respiratory embarrassment and cyanosis.1 Hypoplastic left heart syndrome, coarctation of the aorta, and Ebstein's anomaly of the tricuspid valve all may manifest cardiomegaly and respiratory distress.2 Sepsis,3 hypocalcemia,4 and asphyxia5 have also produced such findings. The following case report is one of congenital liver herniation manifesting respiratory distress and generalized cardiomegaly. Previously reported cases of liver herniation have not mentioned cardiomegaly as an early finding. Report of a Case.—A 6-hour-old boy was admitted because of progressive tachypnea and cyanosis beginning one hour after birth. Vaginal delivery was uneventful, with Apgar scores of 8 and 9 at one and five minutes, respectively. Birth weight was 3,843.8 References 1. Ravitch MM, Handelsman JC: Defects in right diaphragm of infants and children with herniation of liver . Arch Surgery 64:794-802, 1952.Crossref 2. Moss AJ, Adams F: Heart Disease in Infants, Children, and Adolescents . Baltimore, Williams & Wilkins Co, 1977, p 262. 3. Postel J, Schloerb PR: Cardiac depression in bacteremia . Ann Surg 186:74-82, 1977.Crossref 4. Roberton NR, Smith MA: Early neonatal hypocalcemia . Arch Dis Child 50:604-609, 1975.Crossref 5. Rowe RD, Hoffman T: Transient myocardial ischemia of the newborn infant: A form of severe cardiorespiratory distress in full term infants . J Pediatr 79:243-250, 1972.Crossref 6. Bradley JE, Greiner DJ: Diaphragmatic hernia . Am J Dis Child 66:143-148, 1943. 7. Kaufman SA, Madoff IM: Intrathoracic accessory lobe of liver . Ann Intern Med 53:403-407, 1960.Crossref 8. Craighead C, Strug L: Diaphragmatic deficiency in retrocostoxiphoid area . Surgery 44:1062-1069, 1958. 9. Campbell J: The diaphragm in roentgenology of the chest . Rad Clin North Am 1:395-410, 1963. 10. Armstrong RG, Stanford W: Liver scan in the diagnosis of liver hernia . Acad Fam Pract Gen Pract 1:87-89, 1970. 11. Berger RL, Rodriquez-Aquero J, Madoff IM: Herniation of the liver through the foramen of Morgagni . N Engl J Med 276:243-245, 1962.Crossref 12. Vaughn CC: Diagnosis of localized eventration . Dis Chest 54:467-469, 1968.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Nov 1, 1980

References

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