Gaceta médica de México
versão impressa ISSN 0016-3813
URADANETA-CARRUYO, Eliexer et al. Riñón intratorácico en recién nacido con síndrome de dificultad respiratoria por hernia diafragmática congénita. Gac. Méd. Méx [online]. 2004, vol.140, n.2, pp. 219-223. ISSN 0016-3813.
Congenital diaphragmatic hernia (CDH) is found frequently in from 0.17 to 0.57 among 1000 newborns and is associated with intrathoracic kidney (IK) in 0.25%. The objective of the present work was to describe both present pathologies in a newborn and to review the literature in this respect. Clinical case: male newborns, who presented tachypnea sudden and persistent for the first 24 h of life. For the that was physical exam, we included breathing difficulty (eight points of Silverman's) and cyanosis; initial arterial gases: hypoxemia and hypocapnia (acute respiratory failure type I); thorax X-ray; increase of bronchial plot and of parahiliary density; normal lungs, pleuroperitoneal membrane and solid mass superimposed on heart silhouette were observed and confirmed by echocardiogram. Computed axial tomography (CAT) revealed left kidney and part of spleen inside thorax, beside inferior lobe of left lung. Immediately, the patient was mechanically ventilated and after 2 days, was operated sourgically for correction of CDH and descent of left kidney. After surgical intervention, initial syntomatology disappeared and evolution was satisfactory. The present case illustrates how the kidney on occasion can emigrate due to congenital default to the thorax of the wall of the diaphragm and be a casual discovery at the moment of radiologic exploration.
Palavras-chave : Abnormal migration of the kidney; intrathoracic kidney; neonatal breathing difficulty; congenital diaphragmatic hernia; diaphragmatic closure, defect; Bochdalek's hernia.