Hypoplasia of lung with congenital diaphragmatic hernia

Abstract

The features of the hypoplasia associated with congenital diaphragmatic hernia have been studied by serial section of the lungs from two newborn infants with congenital diaphragmatic hernia. The number of bronchial branchings was greatly reduced in all four lungs, the effect being greater in the ipsilateral lungs, with axial pathways giving counts of half the normal values or less, while in the contralateral lungs the count was rather more than half of the normal. Bronchial and bronchiolar regions were both affected: on occasion the bronchiolar region was completely lacking. Thus the brunt of the change falls on the bronchial tree, as the alveoli are relatively less affected, in three of the four lungs the counts being within the normal range. The bronchial arrest is at a stage normally achieved at 10 to 12 1/2 weeks, suggesting that at this time abdominal contents had already invaded the thorax. The arrest of bronchial branching which occurs during the “glandular” phase may be responsible for premature differentiation to the “ alveolar ” stage. The nature of growth following surgical correction of the hernia is discussed in the light of experimental and anatomical studies. © 1963, British Medical Journal Publishing Group. All rights reserved.