A diaphragmatic hernia develops if one or several of the abdominal organs are driven upwards into the chest via an opening in the diaphragm. The diaphragm is a muscle barrier shaped like a dome amidst the chest and cavities of the abdomen. It is responsible for separating the lungs and heart from the abdominal organs.
This is a form of defect that might be present at birth or develops later in life. It is considered as a medical emergency and necessitates immediate surgery.
For a congenital type, it is brought about by abnormalities in the development of the diaphragm as the fetus forms. Any defect in the diaphragm of the fetus allows one or several of the abdominal organs to drive into the chest and take up space where the lungs should be. As an outcome, the lungs could not properly develop.
When it comes to the acquired type, it is usually the result of a blunt or penetrating injury. Vehicular accidents and falls causes most cases of blunt injuries. The penetrating injuries are due to stab or gunshot wounds. Abdominal or chest surgery might be due to accidental damage to the diaphragm.
- Blunt injuries from vehicular accidents
- Gunshot wounds
- Surgical procedures on the abdomen or chest
- Stab wounds
- Falls that directly impact the diaphragm area
Indications of a diaphragmatic hernia
The severity of the symptoms of a diaphragmatic hernia tends to vary depending on its size, causes and the organs affected.
- Difficulty breathing – this is usually severe. In the congenital type, it results from the anomalous development of the lungs while in the acquired type, it occurs when the lungs could not properly function due to crowding.
- Tachypnea – the lungs might attempt to compensate for the diminished levels of oxygen in the body by working rapidly
- Bluish skin discoloration – the body does not receive adequate oxygen from the lungs which causes its bluish appearance
- Diminished or absent breath sounds – the lungs of the child have not properly formed. The breath sounds on the affected side might be absent or difficult to hear
- Tachycardia – the heart strains than normal to supply the body with oxygenated blood
- Bowel sounds in the chest region – this occurs if the intestines move up into the chest cavity
- Abdomen that is not full – the abdomen might be less full that it should be upon palpation. This is due to the abdominal organs that are driven up into the chest cavity.
Both congenital and acquired diaphragmatic hernia require urgent surgery. It is done to get rid of the digestive organs from the chest and moved into the abdomen. The surgeon will also fix the diaphragm.