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.
The diaphragm Respiratory muscles Breathing is usually automatic, controlled subconsciously by the respiratory center at the base of the brain. Breathing continues during sleep and usually even when a person is unconscious.... read more is the muscular sheath that separates the organs of the chest from those of the abdomen.
Most (85%) of diaphragmatic hernias occur on the left side of the body. The stomach, loops of intestine, and even the liver and spleen can protrude through the hernia. If the hernia is large, the lung on the affected side is usually incompletely developed, but the lung on the opposite side also can be affected. About half of children with diaphragmatic hernias also have heart defects Overview of Heart Defects About one in 100 babies is born with a heart defect. Some are severe, but many are not. Defects may involve abnormal formation of the heart's walls or valves or of the blood vessels that enter... read more , kidney defects Kidney Defects There are several different birth defects that affect the kidneys (the two organs that filter waste from the blood to make urine). These defects are not usually apparent at the doctor's examination... read more , or chromosome disorders Overview of Chromosome and Gene Disorders Chromosomes are structures within cells that contain a person's genes. Genes are segments of deoxyribonucleic acid ( DNA) and contain the code for a specific protein that functions in one or... read more .
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.
(See also Overview of Digestive Tract Birth Defects Overview of Digestive Tract Birth Defects A birth defect can occur anywhere along the digestive tract—in the esophagus, stomach, small intestine, large intestine, rectum, or anus. The digestive organs may be incompletely developed or... read more .)
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.
After birth, a chest x-ray Chest Imaging Chest imaging studies include X-rays Computed tomography (CT) CT angiography Magnetic resonance imaging (MRI) read more usually shows the defect.
Treatment of Diaphragmatic Hernia
Oxygen
Surgery
Measures to deliver oxygen, such as a breathing tube and ventilator Mechanical Ventilation Mechanical ventilation is use of a machine to aid the movement of air into and out of the lungs. Some people with respiratory failure need a mechanical ventilator (a machine that helps air get... read more (a machine that helps air get in and out of the lungs), are generally needed.
Surgery soon after the baby is born is required to repair the diaphragm.
