Overview of Hernia of the Diaphragm

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A hernia of the diaphragm, also referred to as a diaphragmatic hernia, is a birth defect that involves a hole in the organ. Other internal organs that are supposed to rest within the abdominal cavity can protrude through this hole, causing many problems for the baby. The most common organs that can be found out of place due to this type of hernia include the stomach, spleen, and small intestine. As they protrude through the hole, the organs can put pressure on the lungs, making it difficult for the baby to breath after birth.

Types of Diaphragm Hernias

One type of hernia of the diaphragm is known as Bochdalek hernia. This opening is typically found on the left side of the organ. On this side, the stomach and half of the intestines are able to move up through the hole.

The second type of diaphragmatic hernia is found on the opposite side of the body, and is called the Morgagni hernia. This allows the liver and other half of the intestines to reach the chest cavity. A Morgagni hernia is far less common than a Bochdalek, representing only two percent of the cases regarding hernias of the diaphragm.

Causes of a Hernia of the Diaphragm

Since it occurs during the fetal stage of development, the only real cause of this form of hernia is the incorrect growth of organs in the fetus’s body. If the diaphragm does not develop as it normally would either naturally or due to an obstruction, there is a good chance a hole will form. Heredity sometimes plays a part in the occurrence of a diaphragm hernia. If two people have a child with this form of birth defect, it is highly possible any further children will have the same condition.

Symptoms of Diaphragm Hernias

The most common symptom for a hernia of the diaphragm is difficulty breathing when the baby is born. This is due to the incomplete development of lung tissue, or because the diaphragm and other organs are in the way of the lungs. Collapsed lungs are common in newborns with this type of hernia. Other signs can include short, rapid breaths, elevated heart rate, and a bluish tint to the baby’s skin which is caused by lack of oxygen.

Diagnosis and Treatment of a Hernia of the Diaphragm

To test for a diaphragmatic hernia, a chest x-ray is typically done to determine whether or not other organs are present in the area. During a full body examination, infants with this type of hernia will usually have one of the following signs:

  • Gas and other sounds from the bowel in the chest
  • The look or feel of organs missing in the abdominal area
  • Chest movements that are not normal

To treat a hernia of the diaphragm, emergency surgery is needed once the problem has been discovered. The misplaced organs will be returned to their intended destination. Once this has been completed, the hole in the diaphragm will be repaired. If the hernia is found to be present in the fetus, surgery may be performed during 24 to 28 weeks of pregnancy.