Congenital Diaphragmatic Hernia: Considerations for the Adult General Surgeon

Xiao-Yue Han; Leigh Taryn Selesner; Marilyn W Butler

doi:10.1016/j.suc.2022.07.007

Congenital Diaphragmatic Hernia: Considerations for the Adult General Surgeon

Surg Clin North Am. 2022 Oct;102(5):739-757. doi: 10.1016/j.suc.2022.07.007. Epub 2022 Sep 7.

Authors

Xiao-Yue Han¹, Leigh Taryn Selesner¹, Marilyn W Butler²

Affiliations

¹ Department of Surgery, Oregon Health and Science University, 3181 Southwest Sam Jackson Park Road, Mail Code L223, Portland, OR 97239, USA.
² Department of Surgery, Division of Pediatric Surgery, Oregon Health and Science University, 501 North Graham Street, Suite 300, Portland, OR 97227-2008, USA. Electronic address: butlerm@ohsu.edu.

PMID: 36209743
DOI: 10.1016/j.suc.2022.07.007

Abstract

The contemporary pillars of congenital diaphragmatic hernia (CDH) management include prenatal diagnosis for multidisciplinary care coordination and counseling, medical optimization after birth, and elective (not emergent) operative repair after stabilization, allowing for improvement in pulmonary hypertension and maturation of lungs. Lung hypoplasia and pulmonary hypertension in infants with CDH represent a medical emergency, not one that necessitates immediate surgery. Many infants surviving CDH repair have significant morbidities that may persist into adulthood. Rare cases of previously occult CDH may present acutely in the older child or adult with nonspecific gastrointestinal or pulmonary symptoms.

Keywords: Bochdalek hernia; CDH; Congenital diaphragmatic hernia; Morgagni hernia.

Publication types

Review

MeSH terms

Adolescent
Adult
Child
Female
Hernias, Diaphragmatic, Congenital* / surgery
Herniorrhaphy
Humans
Hypertension, Pulmonary* / diagnosis
Hypertension, Pulmonary* / etiology
Hypertension, Pulmonary* / therapy
Infant
Lung
Pregnancy
Surgeons*