What is this disease?

• Congenital diaphragmatic hernia occurs when the diaphragm does not form completely, leaving a hole. The hole can be on either side, but in most children it is on the left side. This allows part of the intestine (gut) to develop in the chest. In addition the lungs are often small. In up to 40% of cases there are additional problems like chromosome or heart problems. If these additional problems and other complications are not there, then the outcome for these babies is significantly better. (In the range of 70-80% survival.)

How it is diagnosed?

• In most of the Neonates ,except a few cases, it is picked up in antenatal  USG scans. In older children, it is diagnosed by Chest X-ray and sometimes, CECT  is needed.

How it is treated?

• Diaphragmatic hernias are repaired  by surgery under general anaesthesia.

When it should be operated?

• Newborns with diaphragmatic hernia are assessed immediately by the Neonatologists. Most of the newborn needs help with their breathing by ventilation. The surgeons will only carry out the operation once the baby is stable on a ventilator. The timing and type of operation is decided by the Pediatric  Surgeons, Neonatologist and Pediatric  anaesthetist and discussed with parents. Often, surgery is not performed in immediate newborn period.

Are there other alternative methods of treatment?

• Diaphragmatic hernias must be treated by surgery because if they are not repaired, the baby's breathing problems would get worse as he or she become older. Feeding problems would also get worse with time

What all I need to know before my child surgery?

• Read “All you need to know before your child's surgery” information booklet in website.

How is the surgery done?

• The surgery can be done by either open or Minimally invasive means. Both involves moving the child's intestine back into the abdomen and repair the hole in the diaphragm. It can be repaired either by thoracic or abdominal approach.

Remarks

• For more details of surgery, contact your surgeon

Related Photographs and videos

• Few photographs of steps done by me and video is given here for learning purposes