Diaphragmatic Hernia Flashcards
Anterior mediastinum
2% of all congenital diaphragmatic hernias
Hernia through foramen Morgagni
Adjacent to the xiphoid process
- Usually on the right side
- asmptomatic
- may lead to recurrent chest infections and GIT symptoms
Laparoscopic surgical repair (due to risk of strangulation)
Posterior mediastinum (bochdalek hernia)
95% of congenital diaphragmatic hernias
Usually on the left posterior side
may lead to defect of lung on that side
Diaphragmatic eventration
Abnormal displacement (elevation) of a part/ the whole diaphragm which is otherwise intact
Due to thinning- incomplete muscularization
Congenital diaphragmatic hernia
Fusion of segments of the diaphragm during gestation
Failure to close pleuroperitoneal canal
Most common type: postero-lateral (bochdalek) - 80% occur on the left side
may interfere with lung development, causing mediastinal deviation, and pulmonary hypoplasia
Prenatal diagnosis, cyanosis, mediastinal shift and “empty” (scaphoid) abdomen (the abdomen is sunken in) + CXR (chest x Ray)
Treatment of congenital diaphragmatic hernia
Assisted ventilation, extra corporeal membrane oxygenation (ECMO)
Surgery when the baby is stable
High mortality - 40%
