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Diaphragmatic Hernia

By

Jaime Belkind-Gerson

, MD, MSc, University of Colorado

Reviewed/Revised Aug 2023
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  • A diaphragmatic hernia causes severe difficulty breathing.

  • The diagnosis is based on prenatal ultrasonography or a chest x-ray.

  • The infant is given oxygen, and surgery is done to close the defect.

After delivery, as the newborn cries and breathes, the loops of intestine quickly fill with air. This rapidly enlarging structure pushes against the heart, compressing the other lung and causing severe difficulty breathing, often right after birth. Also, if the lung had been compressed a lot before birth, the blood vessels in the lung become narrowed, which causes high blood pressure in the lung arteries (persistent pulmonary hypertension Persistent Pulmonary Hypertension of the Newborn Persistent pulmonary hypertension of the newborn is a serious disorder in which the arteries to the lungs remain narrowed (constricted) after delivery, thus limiting the amount of blood flow... read more ). The high blood pressure does not let enough blood flow through the lungs and limits the amount of oxygen in the bloodstream. Persistent pulmonary hypertension is the major cause of death among infants who are born with diaphragmatic hernia.

Diagnosis of Diaphragmatic Hernia

  • Before birth, prenatal ultrasonography

  • After birth, a chest x-ray

In some cases, the defect can be detected before birth using prenatal ultrasonography Ultrasonography Prenatal diagnostic testing involves testing the fetus before birth (prenatally) to determine whether the fetus has certain abnormalities, including certain hereditary or spontaneous genetic... read more . Diagnosis of diaphragmatic hernia before birth allows for delivery in a high-risk center and for the staff to prepare for treatment of the defect.

Treatment of Diaphragmatic Hernia

  • Oxygen

  • Surgery

Surgery soon after the baby is born is required to repair the diaphragm.

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