Virtual Pediatric Hospital(tm) : A digital library of pediatric information

Home | About Us | FAQ | Reviews | Search

Additional pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com


Virtual Pediatric Hospital: Thoracopaedia: An Imaging Encyclopedia of Pediatric Thoracic Disease: Case 66 Thoracopaedia: An Imaging Encyclopedia of Pediatric Thoracic Disease

Case 66

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Chief Complaint:
Newborn full term female with an anterior chest and abdominal midline defect.

Clinical History:
This newborn full term female was noted to have ascites on her prenatal ultrasound. During her vaginal delivery, the abdomen could not be delivered due to its large size. Delivery was finally accomplished after removing 200 cc of ascites from the baby by placing a needle through the abdominal wall and uterus of the mother.

Clinical Physical Exam:
Upon delivery the baby was noted to have a midline defect including a split anterior half of the sternum, an omphalocele and a thoracoabdominal ectopic cordis.

icon gifImage 1

Clinical Labs:
Non-contributory

Clinical Differential Diagnosis:
Pentalogy of Cantrell

Imaging Findings:
A chest and abdominal film from the first day of life demonstrated the ectopia cordis and a paucity of bowel gas in the abdomen. Abdominal US from the second day of life (not provided) demonstrated massive ascites, and no hepatic lesions were seen. An echocardiogram noted the presence of double outlet right ventricle.

icon gifImage 2

Imaging Differential Diagnosis:
Ectopia cordis

Operative Findings:
On the second day of life the patient was taken to the operating room for closure of the midline defect. The midline defect extended from just below the umbilicus to halfway up the heart and was a few centimeters wide. The omphalocele sac was excised revealing the apex of the heart and the liver. The pericardium was intact. The diaphragm was intact. The omphalocele was closed by approximating the abdominal fascia. The heart was covered with skin.

icon gifImage 3

icon gifImage 4

icon gifImage 5

Pathological Findings:
None

Final Diagnosis:
Pentalogy of Cantrell

Follow-up and Prognosis:
The patient had an uncomplicated post-operative course. A chest CT exam was performed at 2 weeks of life and demonstrated a very hypoplastic appearing anterior chest wall and a stenosis of the left mainstem bronchus as the cause of the patient's left lung hyperinflation. This was confirmed by endoscopy 3 days later which showed this compression to be due to a pulsating vessel.

icon gificon gifImages 6 and 7

Similar Cases:
None

References:
None

Title Page


Home | About Us | FAQ | Reviews | Search

Additional pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com


Virtual Pediatric Hospital is curated by Donna M. D'Alessandro, M.D. and by Michael P. D'Alessandro, M.D.

Please send us comments by filling out our Comment Form.

All contents copyright © 1992-2024 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.

"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.

Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.

Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.

The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.

URL: http://www.virtualpediatrichospital.org/