Adv Pediatr Surg.  2019 Jun;25(1):20-23. 10.13029/aps.2019.25.1.20.

Congenital Anomaly of Ribs Masquerading as Diaphragmatic Hernia in an Infant: A Case Report

• Mittal P
• Solanki S
• Menon P

• KMID: 2451064
• DOI: http://doi.org/10.13029/aps.2019.25.1.20

Abstract

Congenital absence/hypoplasia/fusion of ribs are very rare anomalies and presentation varies from asymptomatic to life-threatening. Visibly evident cases are straightforward to diagnose but this is not always the case. Familiarity and awareness of these anomalies can help to diagnose cases with subtle signs and symptoms. Proper radiological investigations are vital for anatomical delineation. Absence or hypoplasia of the inferior ribs along with its attached muscles can cause "˜lung hernia' that produces an unstable chest leading to paradoxical respiratory movements. Here, we present a case of hypoplastic and fused ribs in an infant, who presented with respiratory distress and created a diagnostic dilemma.

Keyword

Rib anomalies; Ribs fusion; Abnormal ribs; Diaphragmatic hernia

MeSH Terms

Hernia, Diaphragmatic*
Humans
Infant*
Muscles
Recognition (Psychology)
Ribs*
Thorax

Figure

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  Fig. 1 X-ray chest suggestive of bowel loops herniating into thoracic cavity (black arrow), hypoplastic 7th and 8th rib (white arrow) compare to opposite side and dextrocardia (red arrow).

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  Fig. 2 Computerized tomography with 3-dimensional reconstruction showing hypoplastic 7th and 8th rib (A, black arrow), fused 5th and 6th ribs (B, black arrow), dextrocardia (C, black arrow) and costal cartilage defect (C, white arrow).

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