Diaphragmatic hernia
Congenital diaphragmatic hernias
This is an urgent condition requiring the intervention of a pediatric surgeon. The incidence is 1:10000[1]. They are most often caused by the inability of the pleuroperitoneal membranes to close the pericardioperitoneal channels. As a result, the abdominal organs are pushed into the pleural cavity (the stomach, spleen and intestinal loops are most often involved). The pressure of the inserted organs pushes the heart forward and compresses the lungs. An extensive hernia is accompanied by lung hypoplasia and other complications – 75%[2] of cases end in death. There are 2 types of congenital diaphragmatic hernias. The first of them is Bochdalek's hernia, which occurs in more than 95% [1]of cases. It is located lumbocostally on the left. The second hernia is Morgagni's hernia. This is very rare, as it occurs in less than 5% of cases[1]. It is located sternocostally on the right.
Clinical run
Severe respiratory distress syndrome develops. The chest is asymmetrically arched and there are no visible respiratory excursions. Heart sounds are on the right.
Diagnostics
It is done using a chest X-ray. The contour of the diaphragm is broken. Prenatal diagnosis is performed by sonographic examination.
Hiatal hernias
Hiatal hernias are the result of congenital shortening of the esophagus or its mechanical damage. The upper part of the stomach is drawn into the chest cavity and the stomach is compressed at the level of the diaphragm. Here, too, two cases can occur. If the cardioesophageal transition occurs above the diaphragm, it is a sliding hernia. Her main complication is gastroesophageal reflux. When the cardioesophageal junction forms below the diaphragm, it is a Paraesophageal Hernia.
Links
Following articles
Congenital diaphragmatic hernia
Sources
- MOORE, Keith. Human birth: embryology with a clinical focus. - issue. ISV, 2002. 564 pp. ISBN 9788085866940.
- MUNTAU, Ania. Pediatrics: 130 tabs. - issue. Grada Publishing a.s., 2009. 581 pp. ISBN 9788024725253
