Surgical Conditions of the Diaphragm: Posterior Diaphragmatic Hernias in Infants

Congenital Diaphragmatic Hernia

“…However, some CDH cases may be missed prenatally thus presenting with progressively worsening respiratory distress after delivery 4 as seen in this patient. Examination may reveal a barrel-shaped chest, scaphoid abdomen, absence of breath sounds on the ipsilateral side, shifted cardiac sounds and bowel sounds in the chest 4 .…”

“…Most CDH cases (60%) in the developed world are diagnosed prenatally thus allowing proper antenatal counselling about the severity of the CDH, method of delivery, expected outcomes and long-term morbidities 2,4 . Prenatal ultrasound diagnosis [PUD] helps in making informed decision in planning for the delivery of the baby at the appropriate facility with the necessary skills and personnel.…”

“…Prenatal ultrasound diagnosis [PUD] helps in making informed decision in planning for the delivery of the baby at the appropriate facility with the necessary skills and personnel. PUD has high yield, aids surveillance for in-utero complications and also useful in prognostication 4,5 . Our patient failed to enjoy these benefi ts due to inadequate antenatal care (ANC).…”

“…The hallmark of PUD is the detection of abdominal organs within the thoracic cavity. Other indirect signs are presence of polyhydramnios, abnormal cardiac axis or mediastinal shift 4 .…”

“…Examination may reveal a barrel-shaped chest, scaphoid abdomen, absence of breath sounds on the ipsilateral side, shifted cardiac sounds and bowel sounds in the chest 4 . Chest and abdominal X rays are usually diagnostic showing contralateral mediastinal shift with the stomach and gas fi lled bowels within the chest 6 .…”