Differential Diagnosis for Newborn Boy with Respiratory Distress
- Single most likely diagnosis
- Congenital Diaphragmatic Hernia (CDH): The presence of respiratory distress, decreased lung aeration, and a distended abdomen with a palpable suprapubic mass suggests herniation of abdominal contents into the thoracic cavity, which is consistent with CDH. The flattened facies and clubfeet may also be associated with CDH due to potential genetic syndromes.
- Other Likely diagnoses
- Congenital Pulmonary Airway Malformation (CPAM): This condition could cause respiratory distress and decreased lung aeration, although the presence of a palpable abdominal mass is less typical.
- Esophageal Atresia with Tracheoesophageal Fistula: This condition could lead to respiratory distress, but the absence of feeding difficulties or regurgitation makes it less likely.
- Pneumothorax: Although possible, the lack of a clear history of traumatic delivery or mechanical ventilation makes this less likely.
- Do Not Miss diagnoses
- Pneumoperitoneum: Although less likely given the clinical presentation, a perforated viscus could lead to a life-threatening condition requiring immediate surgical intervention.
- Diaphragmatic Eventration: A condition where the diaphragm is partially or completely replaced by a thin, fibrous layer, which could lead to respiratory distress and require surgical correction.
- Rare diagnoses
- Congenital High Airway Obstruction Syndrome (CHAOS): A rare condition characterized by obstruction of the upper airway, which could lead to respiratory distress, but the clinical presentation would typically include more pronounced upper airway symptoms.
- Abdominal wall defects (e.g., Omphalocele): Although possible, the presence of a suprapubic mass and decreased lung aeration makes this less likely.
- Genetic syndromes (e.g., Fryns syndrome): These syndromes could be associated with congenital diaphragmatic hernia, but the diagnosis would require further evaluation and genetic testing.