Congenital Diaphragmatic Hernia Flashcards
What is congenital diaphragmatic hernia?
The bowel, spleen and liver herniate through the diaphragm into the thorax due to incomplete formation of the diaphragm
What is congenital diaphragmatic hernia due to?
Incomplete formation of the diaphragm
Which part of the diaphragm is typically affected?
The left-sided posterolateral segment
What can a congenital diaphragmatic hernia cause?
Pulmonary hypoplasia and hypertension
How can pulmonary hypoplasia result from a congenital diaphragmatic hernia?
The lungs become underdeveloped because some of the space where they should be is occupied by the herniated organs
How is congenital diaphragmatic hernia diagnosed?
Antenatal ultrasound scan
How can congenital diaphragmatic hernia present?
- severe respiratory disease
- scaphoid (concave) abdomen
- no breath sounds are audible on affected side
- heart sounds may be displaced
What will not be heard on the affected side of someone with congenital diaphragmatic hernia?
No breath sounds on the affected side
How can the heart sounds be affected in someone with congenital diaphragmatic hernia?
Heart sounds may be displaced
What might you see on a USS of someone with congenital diaphragmatic hernia?
Presence of bowel in the thorax
What might you see on a chest x-ray of someone with congenital diaphragmatic hernia?
Loops of bowel in the hemithorax, mediastinal shift
What is the initial management of congenital diaphragmatic hernia?
-Immediate intubation and ventilation
How can a congenital diaphragmatic hernia be managed?
Large nasogastric tube is inserted into the stomach- enable air to escape rather than dilate the bowel and cause further compression of the lungs
What is the purpose of the large nasogastric tube?
Enables air to escape rather than dilate the bowel and cause further compression of the lungs
What is the definitive management of congenital diaphragmatic hernia?
Surgical repair of the diaphragm
