Congenital diaphragmatic hernia: A review

Abstract

Diaphragmatic hernia is one of the most urgent of all neonatal surgical emergencies, causing rapidly progressive and often fatal respiratory distress and acidemia. Congenital diaphragmatic hernia was first described in 1679. In 1761, Morgagni reported a patient with a retrosternal diaphragmatic defect. In 1848, Bochdalek described the more serious hernia which bears his name. Aue attempted the first repair of this anomaly in 1902, and in 1946, Gross achieved the first successful repair of a diaphragmatic hernia in a neonate less than 72 hours old. The incidence of congenital diaphragmatic hernia is about one in 2,200 total births, including stillbirths. 95% of the stillborn and 21% of the live-born infants with this defect have major associated anomalies, including anencephaly, Arnold-Chiari malformation, congenital heart defects, genitourinary anomalies, esophageal atresia, omphalocele, hydronephrosis, cystic kidney, and cleft palate. The occurrence appears to be equally divided between male and female infants, and the infants are rarely premature by weight or age.