CRDAMC Homepage | CRDAMC Library Phone #: (254) 288-8366 | CRDAMC Library Fax #: (254) 288-8368

Search Health Library

Diaphragmatic Hernia

(Hernia—Diaphragmatic; Congenital Hernia of the Diaphragm)

Pronounced: Die-uh-frag-mat-ic hur-nee-uh

Definition

Diaphragmatic hernia is a congenital defect in which an opening is present in the diaphragm at birth. The diaphragm is the partition separating the chest and abdominal cavities. The abnormal opening allows some of the organs typically found in the abdomen to move into the chest cavity. In infants born with diaphragmatic hernia, the abdominal organs push up against the lungs. This prevents the lungs from developing normally.

Diaphragmatic hernia is a serious condition with many potential complications and side effects.

Causes    TOP

Diaphragmatic hernia is caused by a failure of the diaphragm to completely fuse during fetal development.

Diaphragmatic Hernia—Stomach and Intestines Move into Chest Cavity

Herniated Diaphragm
Copyright © Nucleus Medical Media, Inc.

Risk Factors    TOP

Factors that may increase the risk of diaphragmatic hernia include:

  • Chromosomal syndromes
  • Maternal alcohol use
  • Pregestational diabetes in the mother

Symptoms    TOP

Symptoms include:

  • Severe respiratory distress, including rapid breathing, grunting, use of accessory muscles, and bluish tint to the skin from lack of oxygen
  • Asymmetrical or increased diameter of the chest wall
  • Concave abdomen

Diagnosis    TOP

Diagnosis is frequently made on prenatal ultrasound.

If not found prior to birth, a physical exam will be done. A may be done to confirm the presence of abdominal organs in the chest cavity.

Images may be taken of your child's bodily structures. This can be done with achest x-ray.

Treatment    TOP

Treatment includes the following:

Surgery

Surgery to repair the defect and move the organs into the abdomen may be done. Surgery involves either sewing the edges of the diaphragm together, or if the hole is too large, using an artificial patch to fully close the hole. Fetal surgery may be offered at some institutions.

Respiratory Support

Aggressive respiratory support, including intubation with mechanical ventilation, is often needed. Different ventilator strategies may be used. Extracorporeal membrane oxygenation (ECMO), or cardiopulmonary bypass, may be necessary.

Prevention    TOP

There are no current guidelines to preent diaphragmatic hernia.

RESOURCES:

Healthy Children—American Academy of Pediatrics
http://www.healthychildren.org
The American Congress of Obstetricians and Gynecologists
http://www.acog.org

CANADIAN RESOURCES:

About Kids Health—The Hospital for Sick Children
http://www.aboutkidshealth.ca

References:

Congenital diaphragmatic hernia (CDH). Cincinnati Children's website. Available at:
...(Click grey area to select URL)
Updated December 2013. Accessed January 14, 2015.
Congenital diaphragmatic hernia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated May 16, 2016. Accessed September 28, 2016.
Congenital diaphragmatic hernia. UCSF Benioff Children's Hospital website. Available at:
...(Click grey area to select URL)
Accessed January 14, 2015.
2/3/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: McAteer JP, Hecht A, De Roos AJ, Goldin AB. Maternal medical and behavioral risk factors for congenital diaphragmatic hernia. J Pediatr Surg. 2014;49(1):34-38.
Last reviewed March 2017 by EBSCO Medical Review BoardMarcin Chwistek, MD
Last Updated: 5/1/2014

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

To send comments or feedback to our Editorial Team regarding the content please email us at healthlibrarysupport@ebsco.com. Our Health Library Support team will respond to your email request within 2 business days.

Health Library: Editorial Policy | Privacy Policy | Terms and Conditions | Support
36000 Darnall Loop Fort Hood, Texas 76544-4752 | Phone: (254) 288-8000