Anesthetic Management of Acquired Diaphragmatic Hernia After Pulmonary Sequestration Repair in a Child: A Case Report and Updated Review

Acquired diaphragmatic hernia (ADH) is a rare postoperative complication in pediatric patients and may cause abrupt respiratory and hemodynamic deterioration due to intrathoracic herniation of abdominal organs. We report the anesthetic management of a 17-month-old child who developed early postoperative gastric herniation after thoracoscopic resection of pulmonary sequestration. The patient presented with acute respiratory distress, hypoxemia, and mediastinal shift. Anesthetic management included rapid-sequence induction, invasive arterial monitoring, and lung-protective pressure-controlled ventilation with low tidal volumes. A 4-cm diaphragmatic defect was surgically repaired. This case underscores the anesthetic challenges of pediatric ADH and supports applying principles derived from congenital diaphragmatic hernia management.