Congenital posterolateral diaphragmatic hernia

Congenital diaphragmatic hernia

Congenital diaphragmatic hernia continues to be a critical problem in neonatal surgery. Despite the apparent simplicity of the anatomic defect, the physiology is complex, and survival remains uncertain. Surgical success has been achieved, but we recognize that the barrier to survival is pulmonary parenchymal and vascular hypoplasia as well as the complex syndrome of persistent fetal circulation. In many ways the problem of diaphragmatic hernia is as much of an enigma to today's physician-scientist as it was to Bochdalek in the nineteenth century. The treatment of respiratory distress after repair of congenital diaphragmatic hernia has brought out the most creative and innovative efforts of pediatric surgeons in both the laboratory and the intensive care unit.

Hiatus hernia: a complication of postero-lateral diaphragmatic herniation (Bochdalek hernia) in infants

During the six years from January 1973 to Februrary 1979, 23 infants with postero-lateral diaphragmatic (Bochdalek) hernias have been treated in the Paediatric Surgical Unit of the General Infirmary at Leeds. Surgical repair was performed in all cases. Ten patients died. Severe vomiting occurred in seven (54%) of the 13 survivors. Barium meal demonstrated large hiatus hernias in four (31%) of the 13 survivors. This previously unreported complication of Bochdalek hernia repair should be consideredin all patients with vomiting following surgical repair of a Bochdalek hernia.