Journal of Advances in Medicine and Medical Research

Congenital Diaphragmatic Hernia: A Review of Its Management

Rami M. Salama *

Section of Pediatric Surgery, Tanta University Hospital, University of Tanta, 31512 Tanta, Al-Geish St., Egypt.

Hisham A. Almetaher

Section of Pediatric Surgery, Tanta University Hospital, University of Tanta, 31512 Tanta, Al-Geish St., Egypt.

Ashraf A. Elattar

Section of Pediatric Surgery, Tanta University Hospital, University of Tanta, 31512 Tanta, Al-Geish St., Egypt.

Hisham F. Fayad

Section of Pediatric Surgery, Tanta University Hospital, University of Tanta, 31512 Tanta, Al-Geish St., Egypt.

Sherif M. Shehata

Section of Pediatric Surgery, Tanta University Hospital, University of Tanta, 31512 Tanta, Al-Geish St., Egypt.

*Author to whom correspondence should be addressed.

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Abstract

Congenital Diaphragmatic Hernia (CDH) is considered a defect in diaphragm development which occurs congenitally, its incidence is about 1 in 2500 newborns. Major components of CDH are increased pul­monary pressure with fetal circulation persistence, with significant reduction in lung compliance and its tidal volume. Preoperative stabilization and optimization should preceed the surgical repair which is done usually via laparotomy which is considered to be the standard approach. Minimally invasive procedures for CDH repair provides the patient with the benefit of less pain and avoidance of the consequences of thoracotomy or laparotomy compared with the open repair strategy, inspite of prescence of disadvantages mainly from insufflation and CO₂ absorption, but this can be controlled with lower CO₂ pressure, better insufflation instruments and continuous monitoring of blood gases.

Keywords: Congenital diaphragmatic hernia, abnormal pathophysiology, laparotomy, thoracotomy, surgical repair

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