Congenital Diaphragmatic Hernia: A Single Center Experience Over Seven Years
DOI:
https://doi.org/10.37506/mlu.v20i4.1922Keywords:
Congenital diaphragmatic hernia (CDH), Congenital anomalies, Bochdaleck’s CDH, Morgagni’s CDH.Abstract
The congenital diaphragmatic hernia (CDH) is a birth defect in the fetal diaphragm allowing abdominal
contents to protrude to the thoracic cavity. Presence of abdominal contents in the thoracic cavity will affect
the respiratory reserve leading to respiratory symptoms mainly tachypnea. Congenital diaphragmatic hernia
can be presented alone or with other congenital anomalies including cardiac, respiratory, or other anomalies.
CDH can be classified as Bochdaleck, or Morgagni hernia. In 75% of cases CDH is on the left side. The aim
of this study is to view the management of patients with CDH in terms of diagnosis, treatment, and survival
rate. Forty- six cases were studied over seven year period from January 2012 till January 2018. They were
diagnosed based on clinical examination, radiological investigations. 18 (39%) cases were 2-7 days of age.
29 (63%) of cases were presented with tachypnea. Bochdaleck’s CDH is found in 44 patients (96%). 18
patients (39%) were having pulmonary hypoplasia as an associated anomalies with CDH, such anomalies
affect the pulmonary reserve by putting the child in a danger of pulmonary hypertension. Treatment was via
surgical repair done by team of thoracic and pediatric surgeons. In this study, we found delaying surgical
repair after stabilizing the respiratory reserve leads to good postoperative survival, this was proved by high
mortality rate (8 patients 67%) in patients with less than 24 hours age. The aim of this study is to show the
way of management of congenital diaphragmatic hernia in terms of diagnosis, treatment, and the survival
rate.