scholarly journals Outcome of management of congenital diaphragmatic hernia

2015 ◽  
Vol 47 (1-2) ◽  
pp. 12-15
Author(s):  
Amar Kumar Saha ◽  
Md Barkat Ali ◽  
Sunil Kumar Biswas
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Minimal Invasive Surgery ◽  
Open Repair ◽  
Antenatal Diagnosis ◽  
Important Determinant ◽  
Minimal Invasive ◽  
Surgical Correction ◽  
Set Up ◽  
Series Report

Congenital Diaphragmatic Hernia (CDH) is a defect in the dome of diaphragm, more often in left and postero-lateral that permits the herniation of abdominal contents into the thorax. The lungs hypoplasia, pulmonary hypertension and persistent foetal circulation are important determinant of survival. The incidence is <5 in 10,000 live-births. Antenatal diagnosis is ofen made and this may be helpful in postnatal management. Treatment after birth requires all the refinements of critical care prior to surgical correction. The best hospital series report 80-100% survival. Advances in surgical management include delayed surgical approach that enables preoperative stabilization, improved prenatal diagnosis, introduction of minimal invasive surgery and application of extracorporeal membrane oxygenation in addition to the standard open repair. In our short series survival was 100% where surgical correction was made on selective 12 cases of left sided CDH in a non-ICU set-up. DOI: http://dx.doi.org/10.3329/bmjk.v47i1-2.22556 Bang Med J (Khulna) 2014; 47 : 12-15

scholarly journals Congenital Diaphragmatic Hernia: Review of Current Concept in Surgical Management

ISRN Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Emeka B. Kesieme ◽  
Chinenye N. Kesieme
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Surgical Management ◽  
Diaphragmatic Hernia ◽  
Minimal Invasive Surgery ◽  
Pulmonary Hypoplasia ◽  
Open Repair ◽  
Minimal Invasive ◽  
Fetal Intervention ◽  
Prosthetic Devices ◽  
Diaphragmatic Hernias

Congenital diaphragmatic hernias (CDHs) occur mainly in two locations: the foramen of Morgagni and the more common type involving the foramen of Bochdalek. Hiatal hernia and paraesophageal hernia have also been described as other forms of CDH. Pulmonary hypertension and pulmonary hypoplasia have been recognized as the two most important factors in the pathophysiology of congenital diaphragmatic hernia. Advances in surgical management include delayed surgical approach that enables preoperative stabilization, introduction of fetal intervention due to improved prenatal diagnosis, the introduction of minimal invasive surgery, in addition to the standard open repair, and the use of improved prosthetic devices for closure.

Congenital diaphragmatic hernia: associated anomalies and antenatal diagnosis

2004 ◽  
Vol 20 (3) ◽  
pp. 170-176 ◽  
Author(s):  
Jirair K. Bedoyan ◽  
Sean C. Blackwell ◽  
Marjorie C. Treadwell ◽  
Anthony Johnson ◽  
Michael D. Klein
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Antenatal Diagnosis ◽  
Associated Anomalies

Adverse outcome of congenital diaphragmatic hernia is determined by diaphragmatic agenesis, not by antenatal diagnosis

1999 ◽  
Vol 34 (11) ◽  
pp. 1740-1742 ◽  
Author(s):  
S.J Singh ◽  
G.E Cummins ◽  
R.C Cohen ◽  
D Cass ◽  
J.G Harvey ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Antenatal Diagnosis ◽  
Adverse Outcome

scholarly journals Difficult Journey from Delivery to Discharge, Case of Congenital Diaphragmatic Hernia

2015 ◽  
Vol 12 (2) ◽  
pp. 149-150
Author(s):  
RM Karmacharya ◽  
S Dangol ◽  
M Shrestha ◽  
R Koju
Keyword(s):  
Medical Journal ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Surgical Correction

We report a case of congenital diaphragmatic hernia which was diagnosed prenatally for which surgical correction was done on second day of life. The child was discharged in 17 days and has resulted in good post repair condition of patient.Kathmandu University Medical Journal Vol.12(2) 2014: 149-150

CONGENITAL DIAPHRAGMATIC HERNIA: THE IMPACT OF THIS CONGENITAL ANOMALY ON PAEDIATRIC MORBIDITY AND MORTALITY

2003 ◽  
Vol 14 (2) ◽  
pp. 145-154
Author(s):  
JANET R ASHWORTH ◽  
ANTHONY D LANDER
Keyword(s):  
Congenital Anomaly ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Healthcare Professionals ◽  
Antenatal Diagnosis ◽  
Morbidity And Mortality ◽  
Fetal Anomaly ◽  
The Impact ◽  
Clear Information

When an antenatal diagnosis of a fetal anomaly is made, the parents need accurate and clear information regarding prognosis and possible outcomes, to help them make decisions. The healthcare professionals, who are involved in their care and counselling, also need this information.

Congenital diaphragmatic hernia: Antenatal diagnosis and obstetrical management

1985 ◽  
Vol 13 (3) ◽  
pp. 212-215 ◽  
Author(s):  
Robert J. Stiller ◽  
Nancy S. Roberts ◽  
Stuart Weiner ◽  
Beverly Vaughn
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Antenatal Diagnosis ◽  
Obstetrical Management

scholarly journals Longitudinal Follow-Up With Radiologic Screening for Recurrence and Secondary Hiatal Hernia in Neonates With Open Repair of Congenital Diaphragmatic Hernia—A Large Prospective, Observational Cohort Study at One Referral Center

2021 ◽  
Vol 9 ◽  
Author(s):  
Katrin B. Zahn ◽  
Thomas Schaible ◽  
Neysan Rafat ◽  
Meike Weis ◽  
Christel Weiss ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Diaphragmatic Hernia ◽  
Abdominal Wall ◽  
Diaphragmatic Hernia ◽  
Open Repair ◽  
Primary Repair ◽  
Complication Rates ◽  
Referral Center ◽  
Radiologic Imaging

Objective: After neonatal repair of congenital diaphragmatic hernia (CDH) recurrence is the most severe surgical complication and reported in up to 50% after patch implantation. Previous studies are difficult to compare due to differences in surgical techniques and retrospective study design and lack of standardized follow-up or radiologic imaging. The aim was to reliably detect complication rates by radiologic screening during longitudinal follow-up after neonatal open repair of CDH and to determine possible risk factors.Methods: At our referral center with standardized treatment algorithm and follow-up program, consecutive neonates were screened for recurrence by radiologic imaging at defined intervals during a 12-year period.Results: 326 neonates with open CDH repair completed follow-up of a minimum of 2 years. 68 patients (21%) received a primary repair, 251 (77%) a broad cone-shaped patch, and 7 a flat patch (2%). Recurrence occurred in 3 patients (0.7%) until discharge and diaphragmatic complications in 28 (8.6%) thereafter. Overall, 38 recurrences and/or secondary hiatal hernias were diagnosed (9% after primary repair, 12.7% after cone-shaped patch; p = 0.53). Diaphragmatic complications were significantly associated with initial defect size (r = 0.26). In multivariate analysis left-sided CDH, an abdominal wall patch and age below 4 years were identified as independent risk factors. Accordingly, relative risks (RRs) were significantly increased [left-sided CDH: 8.5 (p = 0.03); abdominal wall patch: 3.2 (p &lt; 0.001); age ≤4 years: 6.5 (p &lt; 0.002)]. 97% of patients with diaphragmatic complications showed no or nonspecific symptoms and 45% occurred beyond 1 year of age.Conclusions: The long-term complication rate after CDH repair highly depends on surgical technique: a comparatively low recurrence rate seems to be achievable in large defects by implantation of a broad cone-shaped, non-absorbable patch. Longitudinal follow-up with regular radiologic imaging until adolescence is essential to reliably detecting recurrence to prevent acute incarceration and chronic gastrointestinal morbidity with their impact on prognosis. Based on our findings and literature review, a risk-stratified approach to diaphragmatic complications is proposed.

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