Diaphragmatic Hernias

Diaphragmatic hernias can be divided into two broad categories: congenital diaphragmatic defects and acquired diaphragmatic defects. Congenital diaphragmatic hernias (CDH) occur through embryologic defects in the diaphragm, and most patients present early in life rather than later. However, a subset of adults may present with a smaller congenital hernia that was undetected during childhood.

Diaphragmatic hernias are repaired in an operation under general anaesthetic (so that your baby is deeply asleep), which can last between one to two hours. The surgeons will only carry out the operation once your baby is stable on a ventilator. You may ask - Are there any alternatives? The answer is Not really, no. Diaphragmatic hernias inevitably require treatment, because if they are not repaired your baby’s breathing problems would get worse as he or she grew. Feeding problems would also get worse with time.

A Congenital Diaphragmatic Hernia (CDH) is a defect or hole in the diaphragm which the bowel can pass through. Usually the diaphragm is fully formed by ten weeks of gestation, so any problem can be picked up on an eighteen week ultrasound scan. The commonest hole is on the left side, though they can occur on the right or at the front. Usually only part of the diaphragm is deficient, though an entire half-diaphragm may be missing.

The diaphragm is the muscular sheet that separates the chest from the abdomen. A congenital diaphragmatic hernia occurs when the diaphragm does not form properly during pregnancy. A defect or hole in the diaphragm allows the intestine to push through the muscle, squashing the lungs, and preventing the lungs from developing properly. Holes can occur in either side of the diaphragm but they usually occur in the left-hand side. Babies with a diaphragmatic hernia can have breathing and feeding problems. Up to half of babies with a diaphragmatic hernia also have other serious problems, such as heart problems, kidney problems and neural tube defects, such as cleft lip or palate.