3 learning resources available for this topic
Congenital diaphragmatic hernia (CDH) is a developmental defect where abdominal organs herniate into the thoracic cavity through a diaphragmatic opening, most commonly through the posterolateral foramen of Bochdalek. This condition occurs in approximately 1 in 2,500 to 4,000 live births and represents a surgical emergency requiring immediate intervention.
CDH results from failure of the pleuroperitoneal canal to close completely during embryonic development, typically between 8-10 weeks of gestation. The herniated abdominal contents compress the developing lungs, leading to pulmonary hypoplasia, abnormal pulmonary vascular development, and persistent pulmonary hypertension of the newborn (PPHN).
Neonates present with severe respiratory distress immediately after birth, characterized by cyanosis, tachypnea, and absent breath sounds on the affected side (usually left-sided in 85% of cases). The key diagnostic finding is a scaphoid abdomen with bowel sounds heard in the chest, and chest X-ray reveals bowel loops in the thoracic cavity with mediastinal shift away from the affected side.
Key imaging focus: Bowel loops in thorax, mediastinal shift, absent stomach bubble in abdomen