NICU
Neonates, Infant, Newborn, Baby, Preemie
Diaphragmatic Hernia

What is a Diaphragmatic Hernia?

A diaphragmatic hernia is an opening in the muscle that separates the inner chest area from the inner abdominal area. While the baby is in the uterus, a combination of factors lead to a flaw in where the baby's intestines are located. The intestines are trapped in the upper chest cavity, whereas they should be below.

When this happens, the lungs usually are found to be underdeveloped, and pose serious complications.

There are two types of diaphragmatic hernias:

  • Bochdalek hernia - This happens on the left side of the body,where the stomach and intestines usually present themselves in the chest cavity. This is the most common form.
  • Morgagni hernia - This happens on the right side of the body, where the liver and intestines can be found in in the chest cavity. This form is generally rare.
An infant with a diaprhagmatic hernia will be placed in the NICU, and often placed on a ventilator. This is because the underdeveloped lungs cannot breath on their own, so the machine must do it for them.

This condition can be diagnosed in utero, or after the baby is born. It is considered life-threatening and requires surgery to repair.

Treatment

Surgery is necessary to repair the hernia. The intestines and other organs found out of place will be moved into their normal positions in the abdominal cavity, and the hole in the muscle is repaired.

Due to the infant not being able to breathe on its own, it will be on a ventilator before and after the surgery. Babies with this type or surgery can be in the NICU for several weeks.

There is also the possibility, that if severe enough, the infant could be placed on an ECMO machine, which simulates heart and lung functions so that a baby's body has a chance to rest and recover. This is only temporary, as long term exposure to the machine poses additional risks.

Recovery time can be long, the duration being months or even years.

See also:

University of Virginia Health System - Diaphragmatic Hernia
Children's Hospital Boston - Diaphragmatic Hernia