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Re: Diaphramatic herniaFrom: Jill Houghton (jillhoughton@hotmail.com)Fri Oct 11 13:27:23 2002
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:
At Thu, 10 Oct 2002, Terry J DuBose wrote:
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