ATYPICAL HEMIHEPATECTOMY DURING PRIMARY CDH-REPAIR IN A NEONATE ON ECMO

We report the case of a newborn with a large left-sided congenital dia phragmatic hernia (CDH) who required extra corporeal membrane oxygenat ion (ECMO) for severe respiratory insufficiency. CDH repair had to be performed on bypass circulation. Intraoperatively, an atypical hemihep atectomy of the herniated lobe was conducted, because reposition of th e liver led to a kinking of the vena cava and to a torsion of the righ t lobe, resulting in ischemia and compromised venous flow. The extraor dinary anatomical indication and the potential danger of uncontrollabl e bleeding are discussed.