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Diaphragmatic Hernia (Congenital), Pediatric

Ngoc P. Ly, MD, MPH and Fiona Marion, MB, BCh, BAO Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Defect in the diaphragm allowing herniation of abdominal contents into the thoracic cavity, causing varying degrees of pulmonary hypoplasia

  • There are four types of congenital diaphrag...

DIAGNOSIS

HISTORY

  • Prenatal history:

    • CDH is detected by prenatal ultrasound in >70% cases.

    • Mean gestational age at diagnosis is 24 weeks.

  • Poor prognostic factors:

    • Severe associated anomalies

    • Liver herniat...

TREATMENT

GENERAL MEASURES

  • Intubation and ventilation

    • Intubate in delivery room.

    • Avoid bag and mask ventilation.

  • Nasogastric tube insertion and continuous suction to decompress herniated contents and redu...

ONGOING CARE

PATIENT EDUCATION

  • Many babies with CDH have long-term problems including:

    • Breathing or other lung problems

    • Not gaining weight

    • Digestive problems

    • Learning problems or hearing loss

  • Routine vaccin...

ADDITIONAL READING

  • Bohn D. Congenital diaphragmatic hernia. Am J Respir Crit Care Med.  2002;166(7):911–915. [View Abstract on OvidInsights]

  • Danzer E, Gerdes M, D’Agostino JA, et al. Longitudinal ...

CODES

ICD9

  • 756.6 Anomalies of diaphragm

  • 748.5 Agenesis, hypoplasia, and dysplasia of lung

ICD10

  • Q79.0 Congenital diaphragmatic hernia

  • Q33.6 Congenital hypoplasia and dysplasia of lung

SNOMED

  • 17190001 Congeni...

FAQ

  • Q: What is the recurrence rate?

  • A: Reported rates of recurrence vary from 10% to 50%. Serial screening with CXR and a high index of suspicion is necessary. The typical presentation includes emesis,...

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