--
Allen Worrall
Joseph A Worrall MD RDMS
The Fairbanks Clinic
1919 Lathrop Street, Suite 100
Fairbanks, AK 99701
jworrall@alaska.net
http://www.obgynsono.com
> ----- Original Message -----
From: Jill Houghton
To: Multiple recipients of list ULTRASOUND
Sent: Friday, October 11, 2002 10:28 AM
Subject: Re: Diaphramatic hernia
Congenital Diaphragmatic Hernia (CDH)
The diaphragm separates the chest from the abdominal cavity. This
separation
occurs in utero through the merging of two membranes that normally close
off the
open area between the chest and abdomen. If this area fails to close
completely,
the result is a diaphragmatic hernia. Furthermore, abdominal organs
such as the
small and large intestines, liver, and spleen can move into the chest
cavity
through the abnormal opening. CDH is usually an isolated congenital
abnormality,
but other abnormalities associated with the heart, kidneys, and brain
may also occur. Events leading to CDH begin at 8-10 weeks gestation.
CDH can usually be diagnosed by sonography around 20-25 weeks gestation.
The two most common types of CDHs are Bochdalek hernias and Morgagni
hernias.
Agenesis of the diaphragm is a less common type of a Bochdalek hernia.
Other
diaphragmatic anomalies that are less commonly seen include
paraesophageal
hernias, diaphragmatic eventration, and acquired traumatic hernias.
Bochdalek hernias make up approximately 90% of all cases of CDHs. The
incidence
is 1:2200-5000 live births. They are slightly more common in boys than
girls.
With this type of hernia, the stomach and intestines usually move up
into the
chest cavity. Babies with this type of hernia are also more likely to
have
another birth defect such as a chromosomal abnormality (5-16%) or a
congenital
heart defect (20%).
Morgagni hernias make up only 2% of all CDH cases and are more common in
girls.
With this type of hernia, the bowel penetrates through the diaphragm and
up next
to the heart.
In cases where CHD is the only health problem in a baby, there is only a
2%
chance that it will reoccur in a future pregnancy.
Symptoms of CHD include: difficulty breathing, rapid heart rate,
cyanosis (blue
color of the skin), one side of chest larger than the other, concave
abdomen
Reference:
http://www.cincinnatichildrens.org/Health_Topics/Your_Childs_Health/chest_and_lungs/Conditions_and_Diagnoses/diaphragmatic-hernias.htm
At Thu, 10 Oct 2002, Terry J DuBose wrote:
>
>Victoria, one of my students is currently searching the literature on
>this subject... she submitted a good, brief discussion on the genesis of
>CDH this week. I would like to ask her to respond to your question.
>
>Peace, Terry J DuBose, M.S., RDMS
>Univ. Arkansas for Medical Sciences
>Little Rock, AR USA
>
>On Wed, 9 Oct 2002 21:10:26 -0500 "Victoria Hospodar Valentine"
><vvalentine4@attbi.com> writes:
>> Does a diaphragmatic heria always present at an early fetal age, or
>> can it
>> develop late in the pregnancy? I have been trying to find articles
>> which
>> explain the the process, but most I have found have been case
>> studies. Can
>> anyone point me to some helpful articles?
>>
>> Victoria Valentine, RDMS
>>
