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Postmortem Findings and Clinicopathological Correlation in Congenital Diaphragmatic Hernia

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Pediatric and Developmental Pathology

Abstract

Congenital diaphragmatic hernia (CDH) is a severe life-threatening disease, with an incidence of 3 per 10,000 births, that can occur as an isolated defect or in combination with other congenital anomalies. We reviewed the clinical and autopsy reports of 39 subjects with CDH that were autopsied between 1988 and 2001 to determine whether autopsy had an additional value in the detection of malformations in patients with CDH. We compared the clinical data (including echographic results in some patients) concerning congenital anomalies with the autopsy results. Before autopsy, 6 structural cardiac defects, 3 anomalies of the urogenital system, and 3 anomalies of the digestive tract were observed in 10 patients (clinical and echographic results). However, with postmortem examination, only 4 structural cardiac defects were confirmed, 2 cases showed another cardiac anomaly, and 7 new cardiac defects were found. In the urogenital system, 1 anomaly was confirmed, 1 was not confirmed, and 1 showed another malformation. In addition, in 7 patients new urogenital malformations were found after autopsy. In the digestive tract, all 3 malformations were confirmed, but we found 3 new malformations after postmortem examination. All clinically established dysmorphic features and anomalies of the skeletal system and central nervous system were confirmed by autopsy, and no additional malformations were found. We concluded that postmortem examination has an important additional role in the detection of structural cardiac defects and malformations of the urogenital system and digestive tract in children with CDH.

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Authors and Affiliations

  1. Department of Pathology, Josephine Nefkens Institute, Erasmus MC University Medical Center, Rotterdam, Post Office Box 1738, Rotterdam, DR, 3000, The Netherlands

    Natascha N.T. Goemaere & Ronald R. de Krijger

  2. Department of Pediatric Surgery, Sophia Hospital, Erasmus MC–Sophia, Rotterdam, Post Office Box 1738, 3000, DR, Rotterdam, The Netherlands

    Marieke F. van Dooren & Dick Tibboel

  3. Department of Clinical Genetics, Erasmus MC–University Medical Center, Rotterdam, Post Office Box 1738, 3000, DR, Rotterdam, The Netherlands

    Annelies de Klein

Authors
  1. Marieke F. van Dooren
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  2. Natascha N.T. Goemaere
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  3. Annelies de Klein
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  4. Dick Tibboel
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  5. Ronald R. de Krijger
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Corresponding author

Correspondence to Ronald R. de Krijger.

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Marieke F. van Dooren and Natascha N.T. Goemaere both contributed equally to this article.

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van Dooren, M.F., Goemaere, N.N., de Klein, A. et al. Postmortem Findings and Clinicopathological Correlation in Congenital Diaphragmatic Hernia. Pediatr Dev Pathol (2004). https://doi.org/10.1007/s10024-004-1118-5

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