Congenital diaphragmatic hernia

Case contributed by Dr Mohd Imran

Presentation

Baby did not cry at birth.

Patient Data

Age: Newborn
Gender: Male
Modality: X-ray

Chest X-ray (AP view) of 1 hour old newborn baby shows herniation of bowel contents into left thoracic cavity through diaphragm with displacement of left lung and mediastinum towards right and resultant right lung collapse.

Case Discussion

Congenital diaphragmatic hernias occurs in 1 of every 2000-3000 live births and account for up to 8% of all major congenital abnormalities.

There are 3 main types of congenital diaphragmatic hernia:

  1. posterolateral: Bochdalek hernia
  2. anterior: Morgagni hernia
  3. hiatus hernia

Left-sided Bochdalek hernias are most common, accounting for approximately 85% of cases. Left-sided hernias, lacking the 'protective' effect of the liver may have herniation of both the small and large bowel and intraabdominal solid organs into the thoracic cavity.

When right-sided, only the liver and a portion of the large bowel tend to herniate. Bilateral hernias are uncommon and are usually fatal due to pulmonary hypoplasia.

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Case Information

rID: 7392
Case created: 25th Oct 2009
Last edited: 6th Jan 2016
Inclusion in quiz mode: Included

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