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Unrecognised diaphragmatic hernia in a refugee child: an incidental diagnosis
  1. Dimitri Poddighe1,
  2. Tiziana Boggini2,
  3. Salvatore Savasta3,
  4. Gian Luigi Marseglia3,4
  1. 1Department of Pediatrics, ASST Melegnano e Martesana, Vizzolo Predabissi, Italy
  2. 2Universita degli Studi di Pavia, Pavia, Lombardia, Italy
  3. 3Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, Pavia, Lombardia, Italy
  4. 4Department of Pediatrics, Università degli Studi di Pavia, Pavia, Lombardia, Italy
  1. Correspondence to Dr Dimitri Poddighe, dimimedpv{at}


A 4-year-old boy from Syria was evaluated at the emergency department because of an upper airway viral illness. His physical examination showed a significant intensity reduction of all heart sounds in the absence of any other pathological signs. As the child was affected with Down's syndrome and had suffered thoracic and abdominal trauma because of bombardments, a diaphragmatic hernia was immediately suspected and was confirmed through a simple chest X-ray. A careful clinical examination is crucial in refugee children and adolescents, as several medical and surgical disorders could have escaped previously.

  • emergency medicine
  • paediatrics
  • paediatric surgery

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  • Contributors DP conceived and wrote the manuscript; TB contributed to review the medical literature; SS and GLM provided intellectual contribution.

  • Competing interests None declared.

  • Patient consent Consent obtained from Guardian.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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