Poster électronique

Aspects radiologiques des hernies diaphragmatiques à révélation tardive
R. Salem, B. Zaara, MA. Jellali, A. Zrig, B. Hmida, W. Mnari, W. Harzallah, M. Maatouk, I. Krichene, M. Golli - Monastir - Tunisie
Congrès 2011
Résumé
Objectifs
Rappeler les connaissances embryologiques, physiopathologiques et éthiopathogéniques de la hernie diaphragmatique chez l'enfant. Préciser son aspect épidémiologique et clinique. Insister sur les difficultés diagnostiques des hernies diaphragmatiques à révélation tardive et sur leurs caractéristiques.
Matériels et méthodes
Nous rapportons une étude rétrospective de 32 cas de hernie diaphragmatique à révélation tardive, colligées sur une période de 20 ans dans le service de chirurgie pédiatrique du CHU de Monastir.
Résultats
La symptomatologie clinique chez nos patients était respiratoire dans 59% des cas, digestive dans 6% et mixte dans 25 % des cas. La découverte fortuite a été notée chez 3 patients (9,3%). La radiographie du thorax a été réalisée dans tous les cas, aidée par les opacifications digestives dans 18 cas, l'échographie thoraco-abdominale dans 19 cas et le scanner dans 11 cas. Tous nos patients ont été opérés. La voie laparoscopique a été utilisée dans 18 cas (56%) dont 3 ont été convertis (16%).
Conclusion
La hernie diaphragmatique à révélation tardive peut être découverte quelques jours à plusieurs années après la naissance. Une connaissance des aspects radiologiques possibles de cette pathologie est nécessaire pour garantir une chirurgie réparatrice rapide évitant les complications.
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