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ABC of Pediatric Surgical ImagingBochdaleck Hernia (Congenital Diaphragmetic Hernia/CDH)

ABC of Pediatric Surgical Imaging: Bochdaleck Hernia (Congenital Diaphragmetic Hernia/CDH) Surgeon: A. Alexander A Bochdaleck Hernia (Congenital Diaphragmetic Hernia/CDH) Radiologist: J.W. Lotz Clinical Insights What the Surgeon Needs to Know Malformation of the primordial dia- Lung:head circumference ratio/fetal lung phragm (pleuroperitoneal folds). volume assessment on antenatal imaging. Eighty fi ve percent occur on the left. Has thoracic disease mimicking CDH Pulmonary hypoplasia may be part of the been excluded? abnormality and is the major determinant Presence of stomach or liver in the chest of outcome. (indicators of poor prognosis). Associated congenital abnormalities: Are there any identifi able associated - Cardiac defects present in 63% abnormalities? - Neural tube defects - Uro-genital abnormalities - Chromosomal abnormalities (trisomy) - Pulmonary sequestrations - Anomalies of midgut rotation and fi xation Clinical Diff erential Diagnosis Diaphragmatic: Eventration Pleural: Effusion, empyema Controversies Parenchymal: Consolidation, CCAM, sequestrations, bronchogenic cyst Ante-natal diagnosis of an isolated defect Mediastinal: Cystic hygroma, teratoma, cannot reliably predict the outcome and neurogenic tumours does not require a change in obstetric management. Surgical correction is delayed until cardio-respiratory status has been stabilized (trial of life). Permissive hypercapnoea and role of ECMO (extracorporeal membrane oxygenation). CXR – Bowel gas pattern within the left hemithorax continuous with bowel loops in the abdomen and dis- http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png

ABC of Pediatric Surgical ImagingBochdaleck Hernia (Congenital Diaphragmetic Hernia/CDH)

Editors: Andronikou, Savvas; Alexander, Angus; Kilborn, Tracy; Millar, Alastair J. W.; Daneman, Alan
Alexander, A.; Lotz, J. W.
Springer Journals — Jan 1, 2010
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Publisher
Springer Berlin Heidelberg
Copyright
© Springer-Verlag Berlin Heidelberg 2010
ISBN
978-3-540-89384-4
Pages
16 –17
DOI
10.1007/978-3-540-89385-1_8
Publisher site
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Abstract

Surgeon: A. Alexander A Bochdaleck Hernia (Congenital Diaphragmetic Hernia/CDH) Radiologist: J.W. Lotz Clinical Insights What the Surgeon Needs to Know Malformation of the primordial dia- Lung:head circumference ratio/fetal lung phragm (pleuroperitoneal folds). volume assessment on antenatal imaging. Eighty fi ve percent occur on the left. Has thoracic disease mimicking CDH Pulmonary hypoplasia may be part of the been excluded? abnormality and is the major determinant Presence of stomach or liver in the chest of outcome. (indicators of poor prognosis). Associated congenital abnormalities: Are there any identifi able associated - Cardiac defects present in 63% abnormalities? - Neural tube defects - Uro-genital abnormalities - Chromosomal abnormalities (trisomy) - Pulmonary sequestrations - Anomalies of midgut rotation and fi xation Clinical Diff erential Diagnosis Diaphragmatic: Eventration Pleural: Effusion, empyema Controversies Parenchymal: Consolidation, CCAM, sequestrations, bronchogenic cyst Ante-natal diagnosis of an isolated defect Mediastinal: Cystic hygroma, teratoma, cannot reliably predict the outcome and neurogenic tumours does not require a change in obstetric management. Surgical correction is delayed until cardio-respiratory status has been stabilized (trial of life). Permissive hypercapnoea and role of ECMO (extracorporeal membrane oxygenation). CXR – Bowel gas pattern within the left hemithorax continuous with bowel loops in the abdomen and dis-

Published: Jan 1, 2010

Keywords: Bowel Loop; Extracorporeal Membrane Oxygenation; Pulmonary Hypoplasia; Bronchogenic Cyst; Pulmonary Sequestration

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