Primary Combined Latissimus Dorsi and Serratus Anterior Flap Repair of Right-Sided Congenital Diaphragmatic Agenesis in a Neonate
Journal Title: Sultan Qaboos University Medical Journal - Year 2016, Vol 16, Issue 1
Abstract
Large diaphragmatic defects can be repaired with latissimus dorsi and serratus anterior muscle flaps. We report the frst successful primary repair of complete congenital diaphragmatic agenesis using a combination of autologous living bio-tissue and synthetic mesh in a neonate born in the NMC Specialty Hospital in Dubai, United Arab Emirates, in May 2014. Poor Apgar scores, a scaphoid abdomen and absent breath sounds over the right hemithorax were observed at birth. Chest and abdominal X-rays revealed a diaphragmatic hernia. Te neonate was stabilised using high-frequency oscillatory ventilation, nitric oxide and sildenafl. Te right diaphragm was reconstructed using combined latissimus dorsi and serratus anterior muscle flaps reinforced by a flexible composite mesh. At 12 months old, the infant had normal respiratory function and the diaphragm was intact. No disabilities of the shoulder or scapula were observed. Tis case indicates that a combination of living tissue and synthetic mesh can be used to reconstruct a functional diaphragm with efcient pleuroperitoneal separation.
Authors and Affiliations
Madan Samuel| Department of Surgery, Medcare Hospital, Dubai, United Arab Emirates, Rajiv Parapurath| Department of Neonates, NMC Specialty Hospital, Dubai, United Arab Emirates
Keywords
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