A 1-day-old female presents with severe respiratory distress, cyanosis, and a scaphoid abdomen. Vital signs show HR 165/min, RR 68/min, BP 58/38 mmHg, and SpO2 78% on room air. Physical examination reveals markedly decreased breath sounds over the left hemithorax with bowel sounds audible in the chest. Chest radiograph demonstrates bowel loops in the left thoracic cavity with rightward mediastinal shift. No meconium passage has occurred. Which of the following is the most likely underlying defect?
- A)Abnormal regression of the right fourth aortic arch
- B)Proximal esophageal atresia with distal fistula
- C)Failure of closure of the ductus arteriosus
- D)Failure of fusion of the pleuroperitoneal membraneGABARITO
- E)Deficiency of surfactant production by type II pneumocytes
Explicação
This infant has a Bochdalek congenital diaphragmatic hernia, classically left posterolateral, caused by failure of the pleuroperitoneal membrane to close. Herniation of abdominal contents impairs fetal lung development and produces pulmonary hypoplasia, causin... Ver explicação completa e trilha adaptativa →