Types of Hernia
Types of Hernia > Congenital Hernia
About congenital Hernia?
A congenital hernia is a condition that occurs at birth when a weakness, hole, or aberrant opening in the muscular wall that normally surrounds organs permits those organs or tissues to protrude.
Among these, Congenital Diaphragmatic Hernia (CDH) is a unique form where a developmental abnormality in the diaphragm permits belly contents to herniate into the thoracic cavity, leading to lung hypoplasia and abnormal pulmonary vascular development.
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Types of hernia
Congenital Diaphragmatic Hernia (CDH) : CDH demonstrates the complexities of congenital hernias, emphasising the crucial need for an interprofessional approach in both the immediate and long-term therapy. CDH is further classified into two main types:
Bochdalek hernias
Bochdalek hernias, the most common variety (70% to 75%), are caused by a defect in the postero-lateral region of the diaphragm, with the majority occurring on the left side and less frequently on the right side.
Morgagni Hernia
Morgagni Hernia is less prevalent and occurs anteriorly near the sternum.
Causes
Understanding the root !
The specific cause of Congenital Diaphragmatic Hernia (CDH) is unknown, with continuing research suggesting a complex origin. Key contributors can include:
Genetics: Multiple genes inherited from both parents may play an important role in the development of CDH, indicating a genetic susceptibility.
Environmental reasons: Exposure to certain environmental circumstances or substances during pregnancy is thought to increase the risk of CDH, while the particular reasons are not fully known.
Foetal Malnutrition: Nutritional inadequacies during foetal development may also increase the chance of developing CDH, emphasising the need of maternal nutrition throughout pregnancy.
What Happens If Congenital Hernia is Untreated?
Congenital diaphragmatic hernia (CDH) is a disorder that requires early attention to avoid serious complications. Left untreated, it can progress to severe hypoxemia impairing organ function, pulmonary hypertension, which may result in heart failure, increased susceptibility to lung infections such pneumonia.
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More about congenital hernia
Prevention of congenital hernia
Congenital hernias are difficult to prevent since they are frequently caused by genetic factors and prenatal developmental difficulties. However, several precautions can lessen the danger.
Prenatal Care: Regular prenatal check-ups can aid in monitoring foetal development and detecting potential problems early.
Healthy Lifestyle: Practising a healthy lifestyle during pregnancy, such as eating a balanced diet, avoiding hazardous substances (alcohol, tobacco, and some medications), and limiting environmental exposures, may minimise the chance of congenital anomalies.
Genetic Counselling: For families with a history of congenital hernias, genetic counselling can provide insights and assist in assessing future pregnancy risks.
Prenatal Care: Regular prenatal check-ups can aid in monitoring foetal development and detecting potential problems early.
Healthy Lifestyle: Practising a healthy lifestyle during pregnancy, such as eating a balanced diet, avoiding hazardous substances (alcohol, tobacco, and some medications), and limiting environmental exposures, may minimise the chance of congenital anomalies.
Genetic Counselling: For families with a history of congenital hernias, genetic counselling can provide insights and assist in assessing future pregnancy risks.
Early Signs
The severity of early indicators in babies born with Congenital Diaphragmatic Hernia (CDH) varies, but they often include a combination of respiratory and gastrointestinal problems caused by abdominal organ herniation into the chest. These early indicators necessitate immediate medical attention:
Abnormal respiratory: patterns include difficulty breathing or laboured breathing shortly after birth. A rapid heartbeat occurs when the body strives to adjust for low oxygen levels.
Cyanosis is a blue staining of the skin, particularly around the lips and fingertips, which indicates oxygen deficiency.
Weak Breath Sounds: Typically found on one side of the chest where lung development has been impeded.
Bowel Sounds in the Chest: A rare finding in which digestive sounds are detected in the chest area.
Infants may have difficulty feeding due to incorrect organ location, resulting in poor growth.
Respiratory Distress: Severe breathing difficulties may require mechanical ventilation. Reduced Movement on the Affected Side of the Chest: Respiratory movement is reduced on the side with herniated organs.
Heart murmurs can occur as a result of heart displacement or compression. Pulmonary hypertension is a dangerous increase in blood pressure within the lungs’ arteries that complicates the baby’s respiratory control.
Abnormal respiratory: patterns include difficulty breathing or laboured breathing shortly after birth. A rapid heartbeat occurs when the body strives to adjust for low oxygen levels.
Cyanosis is a blue staining of the skin, particularly around the lips and fingertips, which indicates oxygen deficiency.
Weak Breath Sounds: Typically found on one side of the chest where lung development has been impeded.
Bowel Sounds in the Chest: A rare finding in which digestive sounds are detected in the chest area.
Infants may have difficulty feeding due to incorrect organ location, resulting in poor growth.
Respiratory Distress: Severe breathing difficulties may require mechanical ventilation. Reduced Movement on the Affected Side of the Chest: Respiratory movement is reduced on the side with herniated organs.
Heart murmurs can occur as a result of heart displacement or compression. Pulmonary hypertension is a dangerous increase in blood pressure within the lungs’ arteries that complicates the baby’s respiratory control.
Symptoms
Babies born with CDH may have:
- Abnormal breathing.
- Rapid heart rate.
- Cyanosis is blue discolouration caused by a lack of oxygen.
- Weak breathing noises (typically from one side).
- Bowel sounds in the chest.
- Concave abdomen and barrel chest.
- Abdominal discomfort.
- Constipation caused by bowel blockage.
Treatment
Treatment and rehabilitation for Congenital Diaphragmatic Hernia (CDH) require a comprehensive approach that includes prenatal care, postnatal surgery, and long-term follow-up:
Prenatal Care: CDH is routinely monitored following diagnosis during pregnancy, including procedures such as Fetoscopic Tracheal Occlusion (FETO) to stimulate lung expansion if needed.
Neonatal Care: Intensive care should begin immediately after birth. Babies frequently require oxygen support, which can vary from mechanical ventilation to Extracorporeal Membrane Oxygenation (ECMO) for those with undeveloped lungs.
Once stabilised, newborns have surgery to rearrange organs and restore the diaphragm. A paediatric surgeon performs this procedure under anaesthesia.
Prenatal Care: CDH is routinely monitored following diagnosis during pregnancy, including procedures such as Fetoscopic Tracheal Occlusion (FETO) to stimulate lung expansion if needed.
Neonatal Care: Intensive care should begin immediately after birth. Babies frequently require oxygen support, which can vary from mechanical ventilation to Extracorporeal Membrane Oxygenation (ECMO) for those with undeveloped lungs.
Once stabilised, newborns have surgery to rearrange organs and restore the diaphragm. A paediatric surgeon performs this procedure under anaesthesia.
Recovery
As the baby heals from CDH surgery, they will begin to wean off oxygen assistance and transition to tube feeding until it is safe to remove the breathing tube.
At this point, speech and lactation specialists will help your infant transition to mouth feeding. This process varies in length for each infant, depending on their healing rate and demands.
Our healthcare team will be there to support and guide you throughout this time, ensuring that your baby receives the care he or she requires for a seamless
At this point, speech and lactation specialists will help your infant transition to mouth feeding. This process varies in length for each infant, depending on their healing rate and demands.
Our healthcare team will be there to support and guide you throughout this time, ensuring that your baby receives the care he or she requires for a seamless
FAQ of congenital Hernia
Can congenital hernias be identified before birth? How?
Yes, certain congenital hernias, particularly congenital diaphragmatic hernias (CDH), can be diagnosed before birth using prenatal ultrasounds. Advanced imaging techniques, such as foetal MRI, can also provide thorough results.
What are the long-term consequences of a congenital hernia following surgery?
Long-term consequences might vary greatly, but may include disorders connected to the initial organ displacement, such as respiratory or gastrointestinal problems. Regular follow-up with healthcare practitioners is essential for monitoring and treating these potential problems.
Are genetic tests available for congenital hernias?
While there’s no specific genetic test for all types of congenital hernias, genetic counselling and testing may be recommended in circumstances where a congenital hernia is part of a syndrome or if there’s a family history suggesting a genetic component.
How do congenital hernias influence a child's development?
The effect on development varies, with some children enduring delays, particularly if their hernia greatly hampered their early feeding and breathing. Developmental tests and interventions, such as physical or occupational therapy, may be suggested.