What is a diaphragmatic hernia?

The diaphragm is a dome-shaped muscle wall between the chest and abdominal cavities. It separates your heart and lungs from your abdominal organs (stomach, intestines, spleen, and liver).

A diaphragmatic hernia happens when one or more of your belly organs move up into your chest through a hole in the diaphragm. This hole can be something you are born with or can happen later in life. It is always an emergency and needs surgery right away.

What causes a diaphragmatic hernia?

A congenital diaphragmatic hernia (CDH) happens when the diaphragm does not form correctly while a baby is growing before birth. A hole in the diaphragm lets one or more belly organs move into the chest and take up space where the lungs should grow. Because of this, the lungs cannot grow as they should. Usually, only one lung is affected.

An acquired diaphragmatic hernia (ADH) usually happens after a hard hit or a wound. Most hard hits are from car accidents or falls. Wounds are usually from stabs or gunshots. Surgery on your chest or belly can also accidentally hurt your diaphragm. Sometimes, a diaphragmatic hernia happens for no clear reason and is not found until it causes problems.

What are the risk factors for a diaphragmatic hernia?

Most congenital diaphragmatic hernias have no known cause. Experts think that several things may play a role. Problems with genes, harmful substances in the environment, and nutrition issues may all help cause these hernias. They can also happen along with other problems in organs, like the heart, stomach, or urinary system not developing normally.

The following factors may increase your risk of an acquired diaphragmatic hernia:

• Blunt injuries due to a traffic accident
• Surgical procedures on the chest or abdomen
• Falls that impact the diaphragm region
• Stab wounds
• Gunshot wounds

What are the symptoms of a diaphragmatic hernia?

The severity of symptoms with a diaphragmatic hernia can vary depending on its size, cause, and the organs involved.

Difficulty breathing

This is usually very serious. In a CDH, it happens because the lungs did not grow right. In an ADH, it happens when the lungs cannot work normally because there is not enough space.

Tachypnea (rapid breathing)

Your lungs may try to get more oxygen into your body by breathing faster.

Blue discoloration of the skin

When your body does not get enough oxygen from your lungs, your skin can turn blue.

Tachycardia (fast heart rate)

Your heart may beat faster than normal to try to get more oxygen to your body.

Decreased or absent breath sounds

This is a common sign of CDH because one of the baby's lungs may not have formed right. You may not hear breath sounds on that side or they may be very faint.

Bowel sounds in the chest

This happens when your intestines move up into your chest.

Less full abdomen

When a doctor presses on your belly, it might feel emptier than normal. This is because some of your belly organs have moved up into your chest.

How is a diaphragmatic hernia diagnosed?

Physicians can often diagnose a congenital diaphragmatic hernia in the fetus before birth. Approximately half the occurrences are diagnosed during a fetal ultrasound examination. A greater than usual volume of amniotic fluid (fluid that contains and supports the fetus) is also present in the uterus.

Following delivery, the following abnormalities can be noticed on physical exam:

• Irregular chest motion
• Breathing difficulty
• Blue color to the skin (cyanosis)
• Missing breath sounds on a single side of the chest
• Bowel sounds within chest
• "half-empty" feeling to abdomen

The tests below are usually enough to find out if you have a CDH or an ADH:

• X-ray
• Ultrasound scan (uses sound waves to create images of thoracic and abdominal cavities and contents)
• CT scan (enables viewing directly of the abdominal organs)
• Arterial blood gas test (removes blood directly from an artery and tests for oxygen, carbon dioxide, and acid, or pH level)
• MRI (for more detailed assessment of organs particularly of a fetus)

How is a diaphragmatic hernia treated?

Both congenital and acquired diaphragmatic hernias usually need surgery right away. The surgery moves the belly organs out of the chest and back where they belong. The surgeon then fixes the hole in the diaphragm.

With a CDH, doctors can do surgery as soon as 2 to 3 days after the baby is born. Sometimes surgery is done right away in emergencies, or it may be delayed. Each case is different. First, the baby's condition and oxygen level must be made stable. Doctors use different medicines and ways to help the baby breathe. The best place for these babies is a hospital with a special Neonatal Intensive Care Unit (NICU). Once the baby is stable, surgery can be done.

With an ADH, the patient usually needs to be made stable before surgery. Because most ADH cases are caused by injury, there may be bleeding inside and other problems that need to be treated. That is why surgery should be done as soon as possible.

How is a diaphragmatic hernia prevented?

There is no known prevention for a CDH at this time. Regular and early prenatal care throughout pregnancy is recommended to detect the condition early before birth. This means ideal planning and care prenatally, during delivery, and post-delivery.

Precautions that may prevent you from having an ADH are:

• Safe driving and constant use of a seat belt.
• Avoid activities that could cause hard hits to your belly or chest, like extreme sports.
• Alcohol reduction and drug avoidance which put you at risk for accidents.

Being careful in dealing with sharp objects, like scissors and knives.

What is the long-term prognosis for diaphragmatic hernia?

The prognosis of a CDH depends on the extent of injury to the lungs and the severity of involvement of other organs. Based on current studies, the overall survival rate for congenital diaphragmatic hernias is 70-90 percent.

The chance of surviving an ADH depends on the type of injury, the person's age and health, and how big the hernia is and which organs are involved.

Why choose Tender Palm Super-Speciality Hospital for Diaphragmatic Hernia treatment in Lucknow, India?

Tender Palm Super-Speciality Hospital offers advanced Diaphragmatic Hernia treatment in Lucknow, India, at an affordable cost. We have a team of experienced pediatric surgeons, general surgeons, and critical care specialists, known as some of the best doctors for hernia care. We provide accurate diagnosis with advanced imaging, personalized medical stabilization, and surgical treatment using modern techniques. Our team has decades of experience in successfully treating Diaphragmatic Hernia in Lucknow, India.

To seek an Expert Consultation for Diaphragmatic Hernia treatment in Lucknow, India:

Call us at +91-9076972161
Email at care@tenderpalm.com

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