Gastric Serosal Tear: A Rare Complication of Congenital Diaphragmatic Hernia

Gastric Serosal Tear: A Rare Complication of Congenital Diaphragmatic Hernia

A five-day-old male neonate with 3.2 kg weight was referred for non-bilious vomiting and refusal of feeds. He was delivered by caesarean section and no congenital anomaly had been detected antenatally or at birth.
On examination, he was lethargic, pale, tachypneic, and dehydrated, with mild icterus. There was no cyanosis. He had passed normal meconium at birth. Further physical examination revealed epigastric fullness with tenderness. His investigations showed hemoglobin of 6 grams per decilitre (gm/dL), white blood cell count of 16,000 per cubic millimetre, low serum sodium and potassium, with C-reactive protein (CRP) level of 12 milligrams per decilitre (mg/dL).
The chest X ray showed a left sided diaphragmatic hernia.