MEDIASTINAL STABILIZATION AN EXPANSION PROSTHESIS IN POSTOPERATIVE CONGENITAL DIAPHRAGMATIC-HERNIA WITH SEVERE PULMONARY HYPOPLASIA

The authors illustrate a case of right neonatal congenital diaphragmat ic hernia (CDH) of Bochdalek with major pulmonary hypoplasia and posto perative massive mediastinal displacement to the right, leading to tra cheal compression and recurrent respiratory distress at every attempt to wean the infant from the ventilator. Mediastinal stabilization was obtained by placing an expansion prosthesis (of the cutaneous type) in the right hemithorax, to prevent mediastinal obstruction of the main airways. This procedure may prove to be an original and efficient solu tion for the critical postoperative respiratory obstruction due to sev ere pulmonary hypoplasia and mediastinal mass effect in the newborn wi th CDH. However, this may not prevent progressive scoliosis, a serious problem frequently seen in the absence of one lung.