Study note
PediatricsNewborn Care

Neonatal diaphragmatic hernia

THE CONTEXT
Failure of pleuroperitoneal membrane closure allows intestinal loops to enter the thorax and affect lung development.

Mechanism

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Intestinal loops ascend into the thorax through the diaphragmatic defect and compress the developing lung.
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Compression of the developing lung can result in pulmonary hypoplasia.

Presentation

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Respiratory distress with a scaphoid abdomen at birth should raise suspicion of diaphragmatic hernia.
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Affected neonates can present at any time after birth.

Management

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Bag and mask ventilation should be avoided.
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Surgical repair after stabilization is the treatment of choice.
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