Diaphragmatic Hernia

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    • Congenital Diaphragmatic Hernia
      • Patent pleuroperitoneal canal through the foramen of Bochdalek. (MCQ)
      • Signs and symptoms
        • Significant respiratory distress within first few hours of life
        • Scaphoid abdomen (MCQ)
      • Diagnosis
        • Ultrasound (prenatally) (MCQ)
        • CXR: (MCQ)
          • Bowel gas pattern in hemithorax
          • Mediastinal shift
      • Treatment
        • Respiratory and metabolic support
        • Gastric decompression
        • Surgical correction
        • Extracorporeal membrane oxygenation (ECMO) (MCQ)
      • Prognosis
        • Survival rates are 50% at best.
        • Predictors of mortality: (MCQ)
          • Pulmonary hypoplasia
          • Pulmonary hypertension
      • Clinical Pearls :
        • Congenital diaphragmatic hernia is more common on the left. (MCQ)
        • Clinical scenario: (MCQ)
          • A newborn presents with respiratory distress and a scaphoid abdomen. Diagnosis :  Diaphragmatic hernia
        • Positive pressure ventilation must be delivered by endotracheal (ET) tube, never by mask.
        • Bag and mask ventilation may cause respiratory compromise (Favorite MCQ in AIIMS QB)
        • 95% occur through the posterior foreman of Bachdalek
        • Less than 5% occur through the anterior foreman of Morgagni
        • Usually associated with gastrointestinal malrotation (MCQ)
        • Prognosis is related to the time of onset and degree of respiratory impairment
        • Surgery should be considered early after resuscitation
        • Hernial content are usually reduced via and abdominal approach
        • Hernial sac is excised and diaphragm repaired with nonabsorbable suture or a Gortex patch(MCQ)
        • A Ladd’s procedure may be required for malrotation(MCQ)
        • A chest drain is usually not required (MCQ)
        • Early respiratory failure is assocaited with a poor prognosis


    Congenital Diaphragmatic Hernia Repair
    This 3D medical animation shows a congenital diaphragmatic hernia in which a baby’s abdominal organs push through a defect, or opening, in the baby’s diaphragm during pregnancy. The animation explains the normal function of the diaphragm, and the effects of a diaphragmatic hernia on the developing baby’s lungs. Key steps of the operation to repair a congenital diaphragmatic hernia are depicted.
    Thoracoscopic Diaphragmatic Hernia Repair Surgery
    Some babies are born with a hole in the diaphragm which allows contents of the abdomen to move up into the chest. In the past, these babies need to have a large incision in the abdomen or chest to allow the surgeon to repair the hole in the diaphragm. Using minimally invasive techniques, the surgeons at All Children’s Hospital can in many cases perform the entire repair through incisions only 3 to 5 mm in size. For more information about pediatric surgery,
    iaphragmatic hernia in a cat
    Repair of a peritoneal pericardial diaphragmatic hernia in a cat.
    Laparoscopic Congenital Diaphragmatic Hernia Repair
    Laparoscopic Diaphragmatic Hernia repair
    This is a laparoscopic repair with mesh of a diaphragmatic hernia of Morgagni.
    laparoscopic diaphragmatic hernia repair
    Robotic Repair of Left Diaphragmatic Hernia KM Konstantinidis
    Congenital Diaphragmatic Hernia
    Animation of minimally invasive surgery for Congenital Diaphragmatic Hernia.
    Emergency Diaphragmatic Hernia Repair on a Dog
    A dog in an animal shelter was spayed and crashed during recovery (breathing and heartbeat stopped). CPR brought the dog back to life and x-rays revealed a diaphragmatic hernia. This is a hole in the diaphragm (the muscular separation between the chest cavity where the lungs and heart are located and the abdomen cavity, where the stomach, intestines and most other internal organs are located. On the x-ray that dog’s intestines were inside of the chest cavity with the heart and lungs, causing her to have difficulty breathing. She was taken into surgery in an emergency to repair the hernia. This was the first time that the shelter had ever attempted a diaphragmatic hernia repair on a patient. The surgery was successful and the dog is doing well.
    Surgical Repair Of Diaphragmatic Hernia In Cats.
    Laparoscopic Repair of Posterolateral Diaphragmatic Hernia
    Diaphragmatic Defect on the left diaphragm is treated with laparoscopic method
    Ernia diaframmatica cane-Diaphragmatic hernia in dog – Dott. roberto Bussadori Milano