A diaphragm hernia is a kind of birth defect. It is caused by a hole in the diaphragm that is opened as the baby develops in its mother's uterus. Organs that would normally be present in the abdomen protrude through this opening.
There are two kinds of diaphragm hernias. When the hernia is present on the left side of the body, it is called a Bochdalek hernia. With this type of congenital hernia, the stomach and the intestines protrude through the opening in the diaphragm into the chest cavity.
In a case where the abnormal opening is on the right side, it is known as a Morgagni hernia. The location of the hole means that the baby's liver and intestines move up instead of staying in the abdominal cavity. Of the two types of diaphragm hernias, the Morgagni is the rarer form. It accounts for only two percent of all cases.
When a fetus is developing, the diaphragm forms somewhere between the seventh and tenth week of pregnancy. If the diaphragm doesn't develop normally or a part of the intestine is caught in the diaphragm when it is being formed, a diaphragm hernia may form. Family history does play a part in the likelihood of this type of congenital hernia developing. If the parents have already had a child with a diaphragm hernia, their chances of the condition being present in a subsequent birth increase.
This type of hernia may be detected during a physical exam conducted shortly after birth. A chest X-ray may be ordered to examine the infant's diaphragm, lungs and intestine. A blood test to get an idea of the baby's ability to breathe called an arterial blood gas may also be ordered.
Once the diaphragm hernia has been diagnosed, the baby will likely be admitted to the neonatal intensive care unit at the hospital (NICU). Once in the NICU, the newborn may be put on a ventilator to help them breathe. Another option for doctors is to put the baby on a heart/lung bypass machine until the child's condition stabilizes and the diaphragm hernia can be treated.
Surgery is performed to close the hole and repair the diaphragm hernia. The organs that have moved into the wrong location are put where they should have been originally as part of the process. Regular follow-up medical appointments to further monitor the child's condition will be needed for some time after the surgery.