What is diaphragmatic hernia?
Diaphragm is a large muscle that separates your chest from your abdomen. Diaphragmatic hernia can happen when an infant is born or later in life. Hernia is a hole in your diaphragm. When you have hernia, the organs in your abdomen such as:
Can move up that hole and toward your chest. If this happens in a baby the organs won’t leave any space for the lungs to grow and develop , this can cause difficulty in breathing for the baby.
Most babies that are born with diaphragmatic hernia, also suffer from other defects and health conditions in different parts of their bodies.
What causes it?
There are two types of diaphragmatic hernia and they usually develop because of different reasons.
1- congenital diaphragmatic hernia
This type, also known as CDH, is caused when there is an abnormal hole in the diaphragm of the fetus. While the fetus is growing this defect leads to difficulty in breathing; because organs in the abdomen stop the lungs from developing by pressing them. CDH usually affects one of the lungs. The main reason why this defect happens to the fetus is still unknown.
2- acquired diaphragmatic hernia
Also known as ADH, this type is caused by injuries and blunts, such as:
- Falling from heights
- Stab wounds
- Gunshot wounds
- Traffic accidents
- Injuries during surgeries
What are the risk factors?
The reasons behind why infants are born with this problem are not known yet. But if you are pregnant you should talk to your doctor about ways your fetus can develop healthy. Here are some reasons that can affect a fetus to suffer from diaphragmatic hernia:
1- genetic defect
2- abnormality of chromosomes
4- environmental factors
5- unusual development of gastrointestinal
6- problem with heart development
7- bad development of genitourinary system
If you have experienced one of the conditions below, you may have higher risks of developing this health condition:
1- you have undergone a surgery related to your chest or abdomen
2- some type of traffic accident has happened to you
3- wounds related to gunshot or stabbing near your abdomen or chest area
4- falling from height
How is it diagnosed?
In most cases, this health condition is diagnosed before the baby is born. There are different tests and exams that can diagnose diaphragmatic hernia after the baby is born. Doctors usually use an ultrasound examination to see whether the baby is healthy or not when they’re not born yet.
Some tests include:
1- ultrasound scan
3- CT scan
5- arterial blood gas test
Also there are different physical examinations that help doctors to diagnose diaphragmatic hernia after a baby was born. These physical factors include:
1- chest movements that are unusual
2- skin of the baby turns blue
3- breathing with lots of difficulty
4- hearing bowel sounds on the area near chest
5- abdomen that feels emptier in comparison to other babies
What are the symptoms?
Symptoms usually develop right after the baby is born the severity of these symptoms depends on different factors, such as:
- The cause of it
- How many organs are included
- How big it is
Some of the symptoms include:
1- rapid breathing
Your lungs and heart work faster to get more oxygen as the oxygen level is usually very low.
2- abdomen doesn’t feel full
This happens because the organs that are in the abdomen can move up toward the chest and leave the abdomen empty.
3- breathing hardly
This is one of the most common symptoms in both CDH and ADH.
4- no sounds of breathing
This usually happens in CDH, because one of the lungs isn’t developed well enough.
5- skin turns blue
One of the side effects of not receiving enough oxygen is that the skin turns blue. This condition is called cyanosis.
6- fast heart rate
Your heart pumps quicker to get enough oxygen to your blood and therefore your other organs.
7- hearing bowel sounds in chest
This happens when the intestine has moved to the chest area.
How to prevent it?
There are no scientific preventions from diaphragmatic hernia. If you have a family history with this health condition, it’s better to talk to your doctor before getting pregnant. Also checking the fetus and taking tests to make sure they’re healthy is another important step.
In order to prevent ADH you have to be cautious. Stay away from sharp objects while you’re exercising, try to drive safely, be careful with alcohol and drugs as they increase the risks of accidents and avoid activities that lead up to injury or blunt to your chest or abdomen.
How to treat it?
The only way to treat this health condition is through surgery. In both CDH and ADH cases, doctors try to perform a surgery to remove the organs from the chest area to the abdomen and also close the hole in the diaphragm muscle. Some infants are put in machines that help them breathe during and after the surgery.
Usually when an infant is born with this condition, the surgery happens within the next 48 to 72 hours. Of course the timing depends on the symptoms and other factors and it varies from baby to bay. Up to 80% of the babies that undergo this surgery survive.
As for ADH cases, the results of the surgery depends on different factors such as:
- How damaged the lungs are
- What organs are involved
- Overall health condition
- Size of organs
- Size of the hernia (hole)
- Type of injury