Congential diaphragmatic hernia results from herniation of the intestinal tract through a defect. 85% of the cases the defect is of the left hemidiaphragm; less than 1% is bilateral. Esophageal atresia is characterized by incomplete formation of the esophagus.
Congential diaphragmatic hernia results from herniation of the intestinal tract through a defect. 85% of the cases the defect is of the left hemidiaphragm; less than 1% is bilateral. Esophageal atresia is characterized by incomplete formation of the esophagus.
Congential diaphragmatic hernia results from herniation of the intestinal tract through a defect. 85% of the cases the defect is of the left hemidiaphragm; less than 1% is bilateral. Esophageal atresia is characterized by incomplete formation of the esophagus.
through a defect in the diaphragm. It results from the failure of closure of the pleuroperitoneal canal during the eighth week of fetal life. The defect most frequently occurs at the foramen of Bochdalek. The defect can vary from several centimeters to complete absence of the involved hemidiaphragm
In 85% of the cases the defect is of
the left hemidiaphragm; less than 1% is bilateral. TP After delivery, infants present with respiratory distress, cyanosis, and scaphoid abdomen.
Immediate tracheal intubation and placement of
a nasogastric tube are undertaken to prevent gaseous distention of the herniated intestine. Treatment with nitric oxide was initially a mainstay of therapy, but recent studies may show that it provides no benefit. ECMO may be necessary in the more severe cases. The timing of surgical repair is based on the infant's respiratory status. Most centers delay repair of the diaphragm for a number of days to allow time for the pulmonary vasoreactivity to diminish
Esophageal atresia is characterized
by incomplete formation of the esophagus and is frequently associated with a fistula between the trachea and the esophagus. Many anatomic variations of esophageal atresia with or without tracheoesophageal fistula have been described
the neonate with esophageal atresia has
copious, white, frothy bubbles of mucus in the mouth and sometimes the nose. These secretions may clear with aggressive suctioning but eventually return. The infant may experience episodes of coughing, choking, and cyanosis, especially during feeding. Abdominal distention may be prominent if a fistula between the distal esophagus and the trachea is present. The abdomen will be scaphoid if no fistula exists.
Diagnosis can be made by failure to
pass a feeding tube into the stomach; however, it needs to be confirmed by radiographic study of the chest and abdomen with the feeding tube in place
A suction catheter (Replogle
catheter, No. 8 to 10 French gauge) is placed in the upper esophageal pouch to suction secretions. An infant with respiratory distress requires endotracheal intubation and mechanical ventilation
CHARGE is an acronym for a cluster
of anomalies that includes C oloboma, H eart defects, choanal A tresia, R etardation of growth and development, and G enital and E ar anomalies. Other associated features may include tracheoesophageal anomalies, urinary tract abnormalities, deafness, and characteristic facial and hand
VACTERL is an acronym for a cluster
of abnormalities consisting of V ertebral anomalies, A nal atresia, C ardiac anomaly, T racheo E sophageal fistula or atresia, R enal and L imb (typically radius) abnormalities. The patient also may have associated growth deficiency. Occasionally, the acronym has an S at the end for association with single