DIAPHRAGMATIC HERNIA

Maldevelopment of the septum transversum result in diaphragmatic hernia. The causes of diaphragmatic hernia are two types –

1-Congenital

2-Acquirerd -the acquired diaphragmatic hernias are very often due to stab injuries of the abdomen.

Majority of congenital hernias present shortly after birth.

However, a few cases present late to the hospital and most of such children are treated for recurrent respiratory tract infection elsewhere, without proper diagnosis.

80/ of congenital diaphragmatic hernias occur on the left side.

Site of congenital diaphragmatic hernia –

1-hernia through foramen of Bochdalek – this is the most common diaphragmatic hernia in children. These hernias occur through the respiratory distress shift of medistinum .

2- Hernia ion through the foramen of Morgagni (parasternal Hernia) these hernias present in late childhood or in adult life with features of (sub acute) intestinal obstruction or pain in the right hypochondrium or tightness in the chest. This is because majority of them contain transverse colon.

3-herniation through the central tendon –

This can affect the right or the right or the left apex of the cupola or the central portion. Funds of the stomach on the left side and a portion of the liver on the right side may be the contains.

These cases are very often diagnosed accidentally by routine chest radiograph.

4-eventration –due to paralysis or atrophy of the muscle fibbers, one or both hemi diaphragms are weak and they are elevated in position. Truly speaking this is not a hernia, but sign and symptom are almost like other type of hernia.Maldevelopment of the septum transversum result in diaphragmatic hernia. The causes of diaphragmatic hernia are two types –

1-Congenital

2-Acquired -the acquired diaphragmatic hernias are very often due to stab injuries of the abdomen.

Majority of congenital hernias present shortly after birth.

However, a few cases present late to the hospital and most of such children are treated for recurrent respiratory tract infection elsewhere, without proper diagnosis.

80/ of congenital diaphragmatic hernias occur on the left side.

Site of congenital diaphragmatic hernia –

1-Hernia through foramen of Bochdalek – this is the most common diaphragmatic hernia in children. These hernias occur through the respiratory distress shift of medistinum .

2- Hernia ion through the foramen of Morgagni (parasternal Hernia) these hernias present in late childhood or in adult life with features of (sub acute) intestinal obstruction or pain in the right hypochondrium or tightness in the chest. This is because majority of them contain transverse colon.

3-herniation through the central tendon –

This can affect the right or the right or the left apex of the cupola or the central portion. Funds of the stomach on the left side and a portion of the liver on the right side may be the contains.

These cases are very often diagnosed accidentally by routine chest radiograph.

4-eventration –due to paralysis or atrophy of the muscle fibbers, one or both hemi diaphragms are weak and they are elevated in position. Truly speaking this is not a hernia, but sign and symptom are almost like other type of hernia.