St. Luke's Hospital
Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
Find a Physician Payment Options Locations & Directions
Follow us on: facebook twitter Mobile Email Page Email Page Print Page Print Page Increase Font Size Decrease Font Size Font Size
America's 50 Best Hospitals
Meet the Doctor
Spirit of Women
Community Health Needs Assessment
Home > Health Information

Multimedia Encyclopedia

    Print-Friendly
    Bookmarks

    Diaphragmatic hernia

    Hernia - diaphragmatic; Congenital hernia of the diaphragm

    A diaphragmatic hernia is a birth defect in which there is an abnormal opening in the diaphragm, the muscle that helps you breathe. The opening allows part of the organs from the belly (stomach, spleen, liver, and intestines) to go up into the chest cavity near the lungs.

    Causes

    A diaphragmatic hernia is caused by the improper joining of structures during fetal development. As a result, the abdominal organs such as the stomach, small intestine, spleen, part of the liver, and the kidney appear in the chest cavity. The lung tissue on the affected side is thus not allowed to completely develop.

    Congenital diaphragmatic hernia is seen in 1 out of every 2,200 to 5,000 live births. Most affect the left side. Having a parent or sibling with the condition slightly increases your risk.

    Symptoms

    Severe breathing difficulty almost always develops shortly after the baby is born, because of ineffective movement of the diaphragm and crowding of the lung tissue, which causes collapse.

    Other symptoms include:

    • Bluish colored skin due to lack of oxygen
    • Rapid breathing (tachypnea)
    • Fast heart rate (tachycardia)

    Exams and Tests

    The pregnant mother may have excessive amounts of amniotic fluid. Fetal ultrasound may show abdominal contents in the chest cavity.

    Examination of the infant shows:

    • Irregular chest movements
    • Absent breath sounds on affected side
    • Bowel sounds heard in the chest
    • Abdomen feels less full on examination by touch (palpation)

    A chest x-ray may show abdominal organs in chest cavity.

    Treatment

    A diaphragmatic hernia is an emergency that requires surgery. Surgery is done to place the abdominal organs into the proper position and repair the opening in the diaphragm.

    See: Diaphragmatic hernia repair - congenital

    The infant will need breathing support until he or she recovers from surgery. Some infants are placed on a heart/lung bypass machine, which gives the lungs a chance to recover and expand after surgery.

    If a diaphragmatic hernia is diagnosed during pregnancy (around 24 to 28 weeks), fetal surgery may be considered.

    Outlook (Prognosis)

    The outcome of surgery depends on how well the baby's lungs have developed and also on whether there are any other congenital problems. Usually the outlook is very good for infants who have enough lung tissue and have no other problems.

    With advances in neonatal and surgical care, survival is now greater than 80%.

    Possible Complications

    • Lung infections
    • Other congenital problems

    When to Contact a Medical Professional

    Go to the emergency room or call the local emergency number (such as 911). A diaphragmatic hernia is a surgical emergency.

    Prevention

    There is no known prevention.

    References

    Ehrlich PF, Coran AG. Diaphragmatic hernia. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 101.

    Keijzer R, Puri P. Congenital diaphragmatic hernia. Semin Pediatr Surg 2010 Aug; 19(3): 180-5.

    Puri P, Nakazawa N. Congenital diaphragmatic hernia. In: Puri P, Hollworth M, eds. Pediatric surgery: diagnosis and management. Springer, 2009: chapter 31.

    BACK TO TOP

    • Infant diaphragmatic her...

      illustration

    • Diaphragmatic hernia rep...

      Presentation

      • Infant diaphragmatic her...

        illustration

      • Diaphragmatic hernia rep...

        Presentation

      Tests for Diaphragmatic hernia

        Review Date: 6/18/2011

        Reviewed By: Kimberly G Lee, MD, MSc, IBCLC, Associate Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

        The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
        adam.com

        A.D.A.M. content is best viewed in IE9 or above, Fire Fox and chrome browser.


        Back  |  Top
        About Us
        Contact Us
        History
        Mission
        Locations & Directions
        Quality Reports
        Annual Reports
        Honors & Awards
        Community Health Needs
        Assessment

        Newsroom
        Services
        Brain & Spine
        Cancer
        Heart
        Maternity
        Orthopedics
        Pulmonary
        Sleep Medicine
        Urgent Care
        Women's Services
        All Services
        Patients & Visitors
        Locations & Directions
        Find a Physician
        Tour St. Luke's
        Patient & Visitor Information
        Contact Us
        Payment Options
        Financial Assistance
        Send a Card
        Mammogram Appointments
        Health Tools
        My Personal Health
        mystlukes
        Spirit of Women
        Health Information & Tools
        Clinical Trials
        Health Risk Assessments
        Employer Programs -
        Passport to Wellness

        Classes & Events
        Classes & Events
        Spirit of Women
        Donate & Volunteer
        Giving Opportunities
        Volunteer
        Physicians & Employees
        For Physicians
        Remote Access
        Medical Residency Information
        Pharmacy Residency Information
        Physician CPOE Training
        Careers
        Careers
        St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
        Copyright © St. Luke's Hospital Website Terms and Conditions  |  Privacy Policy  |  Patient Notice of Privacy Policies PDF Sitemap St. Luke's Mobile