A Clinical Observation of Congenital Diaphragmatic Hernia

ABSTRACT

Diaphragnatic hernia is one of the surgical emergencies of the childhood because of the life-threatening cardiorespiratory embarrassment frequently associated with it. This congenital condition is characterized by varying degrees of protrusion of the abdominal viscera into the thoracic cavity through an abnormal opening in the diaphragm this opening results from a defect in the complex embryologic developement of the diaphragm between the thoracic and abdominal cavities. We expenienced 16 cases of congenital diaphragmatic hernia which were diagnosed at Severance Hospital from May 1964 to April 1977, and obtained the following results. 1) In 16 cases, male were ten and female were six. They were eleven cases of bochdalek hernia, two cases of diaphragmntic eventration, one case of hiatal and two undetermined. 2) Onset of symptoms were within 24 hours in 7 cases and in the rest cases symptoms were occured up to 24 months. 3) Most common symptoms were dyspnea and cynosis. 4) Most common signs were decreased breathing sound on affected lung, PMI shifting, scaphoid abdomen and subcostal retraction. 5) Combined anomalies were band adhesion of intestinal loop, hypoplasia of left lung etc. 6) Small intestine were more frequently herniated as well as large intestine. 7) mortality rate between abdominal procedure and thoracic procedure was equal. 8) Cases whose symptoms were occured within 24 hours were 7, 5 of these 7 were expired, Expired cases were associated with marked respiratory difficulties and pulmonary hypoplasia.