PMC4724109_01
Fetal magnetic resonance imaging (a) and photograph at surgery (b) of Case 1. a Herniation of abdominal organs into the left pleural cavity ( ) and intestine into the umbilical cord ( ) were detected by magnetic resonance imaging at 34 weeks of gestation. b The spleen and small intestine were removed from the left pleural cavity and reduced into the abdomen ( ). Anterior, posterior, and left lateral posterior sides of diaphragm were formed but mediastinal side, especially around the esophageal hiatus of diaphragm, was defective ( )
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Fig1
At 33 to 34 weeks' gestation, fetal CDH and omphalocele had been detected by fetal ultrasonography and magnetic resonance imaging (MRI; Fig. 1a). The posterior, anterior, and lateral borders of the defect consisted of diaphragmatic muscle, but the medial border was formed by the esophageal hiatus (Fig. 1b).
PMC4724109_02
Radiograph on day 161 of life (a) and photograph during direct closure of the diaphragm (b) in Case 2. a On day 161, intestinal gas was detected in the mediastinum ( ). b A retrosternal hernial orifice ( ) was observed at operation and the defect was closed directly
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Fig2
On day 161 after his birth, intestinal gas in his mediastinum was detected radiographically (Fig. 2a), although his respiratory condition was unchanged. Direct closure of a retrosternal defect in his diaphragm measuring 2.5x3.5 cm (Fig. 2b) was performed along with resection of his hernial sac.