Congenital diaphragmatic hernia : prevalence and management

Abstract EN

Background : The morbidity and mortality of congenital diaphragmatic hernia is related to the severity of lung hypoplasia, pulmonary hypertension and associated anomalies.

Patients and methods : fifty nine consecutive patients with surgically proved diaphragmatic hernia (excluding hiatal hernia) were included in this prospective study.

All patients were seen at Al-Kadhymia hospital for children and Al-Mustansyria hospital, in the period from January 2003 to December 2009.

Plain chest x-ray was done for all the patients understudy, but barium study was arranged for only nine patients.

Results : There were fifty nine child with congenital diaphragmatic hernia, Bochdalek hernia forms 81.4 % of all congenital diaphragmatic hernia, the peak incidence at presentation was in the neonatal period (80,2 %) of patients.

The chest roentgenographic appearance was diagnostic in 87.5 % of the patients with Bochdalek while Morgagni hernia in 62.5 % of patients was diagnostic.

Morgagni hernia constitutes 13.6 % of the congenital variety, commonly to the right side (87.5 % of patients).The incidence of presentation beyond the neonatal period was 50 % of cases .

Absence of hemidiaphragm was found in 5 % of the congenital variety , the chest x-ray was diagnostic in all patients.

Conclusion : The chest roentgenograph (frontal view) is a very helpful diagnostic tool for the diaphragmatic hernia with a high diagnostic accuracy (73.7 %).