RECENT TRENDS IN MANAGEMENT OF CONGENITAL DIAPHRAGMATIC HERNIA
Mohammed Abdel Aziz Sallam;
Abstract
T
he incidence of congenital diaphragmatic hernia has been reported as 1 in 3000–5000 live births, however, in population studies – including cases resulting in premature terminations, still births and neonatal deaths prior to transfer to tertiary centres – the incidence approaches 1 in 2000.
Over the past two decades, antenatal diagnosis rates have increased, the pathophysiology has become better understood, and advances in clinical care have occurred. The significant long-term morbidity has become apparent, and the need for long-term follow-up established.
Herniation of abdominal contents occurs most often, inover 95% of cases, through the posterior foramen of Bochdalek, posterior and lateral to the spine, with 80%occurring on the left side. Less commonly, retrosternalherniation occurs, through the foramen of Morgagni.
The exact mechanism of lung hypoplasia in CDH is a matter of debate. The traditional view involved a diaphragmatic defect resulting from failed closure of the pleuroperitoneal canals by the end of the embryonic period (weeks 8–10 of gestation). Herniation of abdominal viscera into the thorax resulted in compression of the developing ipsilateral lung, and to a lesser extent the contralateral lung.
he incidence of congenital diaphragmatic hernia has been reported as 1 in 3000–5000 live births, however, in population studies – including cases resulting in premature terminations, still births and neonatal deaths prior to transfer to tertiary centres – the incidence approaches 1 in 2000.
Over the past two decades, antenatal diagnosis rates have increased, the pathophysiology has become better understood, and advances in clinical care have occurred. The significant long-term morbidity has become apparent, and the need for long-term follow-up established.
Herniation of abdominal contents occurs most often, inover 95% of cases, through the posterior foramen of Bochdalek, posterior and lateral to the spine, with 80%occurring on the left side. Less commonly, retrosternalherniation occurs, through the foramen of Morgagni.
The exact mechanism of lung hypoplasia in CDH is a matter of debate. The traditional view involved a diaphragmatic defect resulting from failed closure of the pleuroperitoneal canals by the end of the embryonic period (weeks 8–10 of gestation). Herniation of abdominal viscera into the thorax resulted in compression of the developing ipsilateral lung, and to a lesser extent the contralateral lung.
Other data
| Title | RECENT TRENDS IN MANAGEMENT OF CONGENITAL DIAPHRAGMATIC HERNIA | Other Titles | الطــرق الحديثــة لعــلاج الفتق الحجابى الخلقى | Authors | Mohammed Abdel Aziz Sallam | Issue Date | 2014 |
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