RESUMEN
Diaphragmatic hernia in children is uncommon, especially when not congenital. We present a case of an 11-year old boy with a diaphragmatic hernia caused by a rib osteochondroma. The osteochondroma was surgically removed and the laceration in the diaphragm was repaired. This case shows the importance of being familiar with acquired diaphragmatic hernia in children, to recognize and prevent possible complications in an early stage.
RESUMEN
INTRODUCTION AND IMPORTANCE: Rib osteochondromas are rare genetic disorders, which can present as bony exostosis causing compression, impingement and damage to surrounding vessels, organs and structures within the thoracic cavity. The objective of this study was to clearly describe a rare presentation of rib osteochondromas in a pediatric patient along with managing techniques. CASE: A 9-year-old girl was admitted to the hospital due to shortness of breath on exertion. Physical examination did not reveal any abnormalities except for small bony projections over the left 5th rib. Computed tomography (CT) scan showed a bony lesion on the left fifth rib causing cardiac compression. Video-assisted thoracoscopy (VAT) was done, which showed a bony exostosis compressing the left ventricle, the lesion was resected without any complications. Final pathology confirmed the diagnosis of osteochondroma measuring 2.0 cm × 2.0 cm × 1.5 cm, along with a thickness of 0.4 cm. Post-operative recovery was well, with no morbidities and the patient was discharged without any complications. On the post-operative follow up, the patient showed significant improvement in her symptoms. CLINICAL DISCUSSION: Our reported case is a rare example of a solitary costal osteochondroma leading to serious complications because of its shape, size, and location. Previous reports have not addressed any significant traumatic event or impact prior to the occurrence of symptoms related to the cases, including the case of our patient. Cases of rib exostosis were surgically approached using different techniques most often through thoracotomy. CONCLUSIONS: Rib osteochondromas are rare benign bony lesions which can cause cardiac symptoms secondary to direct compression. They can be resected safely via video assisted thoracoscopy (VAT) or limited thoracotomy.
RESUMEN
A seven year-old boy with several painless masses on the ribs and shoulder was referred to our hospital. The masses were so prominent that they prevented the child's sleep. Since the patient had been ridiculed by his friends due to the rib prominences, he had refused to attend school. After clinical and radiological evaluations, the masses were diagnosed as hereditary multiple exostoses of the shoulder and ribs. He underwent surgery for cosmetic reasons resulting in the patient's return to a normal life.