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Article
Types and Outcome of Congenital Diaphragmatic Hernia in Children in Basrah

Authors: Haithem Husian Ali --- Amer Abd Allah Ejrish --- Sadik Hassan Kadhem
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 2 Pages: 264 -270
Publisher: Babylon University جامعة بابل

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Abstract

A prospective study that review the types of congenital diaphragmatic defects in pediatric age groups in Basra and their outcome, to describe the demography of diaphragmatic defects and to assess their mortality and morbidity. This study was conducted at the neonatal intensive care unit and surgical ward of the Basra children specialty hospital. The medical records of 67 diaphragmatic defects patients, admitted to the hospital from July 2013and July 2015. Data for patient demographics, associated congenital anomalies, and mortality were collected in this study in addition to the types of diaphragmatic defects. In this study Bochdalek hernia is the commonest type of diaphragmatic defects in all age groups (64.2%), followed by diaphragmatic event ration (13.4%), hiatus hernia (11.9%), Morgagni hernia (4.5%), congenital central hernia (4.5%), and finally absent hemi diaphragm (1.5%). Male is affected more than female in all age groups. Shortness of breath is the presenting feature in all age groups with predominance in neonates. Vomiting is the second presenting feature, especially in infant and older children. Associated anomalies occur in about 19.4%. Overall complication rate was 24.1 and the survival rate was 80.3%. It may not reflect the real survival because many fetal and post-delivery deaths occurred and not registered in our society.One should have a high index of suspicion regarding diaphragmatic defects especially those neonates presenting with shortness of breath. Most neonates with diaphragmatic defects are diagnosed by plain chest x-rays (88.2%) so that we should avoid injudicious use of contrast study or CT scan for the diagnosis of diaphragmatic defects. High survival rate may not reflect the real event because many patients died before, during, or just after delivery so that prenatal diagnosis and management of diaphragmatic defect must be encouraged.


Article
Congenital diaphragmatic hernia: prevalence and management

Authors: Raghad J. Abulhab --- FaikT.Al-Gailani --- Hasan K. Gatea
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 4 Pages: 380-384
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The morbidity and mortality of congenital diaphragmatic hernia is related to the severity of lung hypoplasia ,pulmonary hypertension and associated anomalies.
Patients and methods: fifty nine consecutive patients with surgically proved diaphragmatic hernia (excluding hiatal hernia) were included in this prospective study. All patients were seen at Al-Kadhymia hospital for children and Al-Mustansyria hospital, in the period from January 2003 to December 2009.Plain chest x-ray was done for all the patients understudy,but barium study was arranged for only nine patients.
Results: There were fifty nine child with congenital diaphragmatic hernia ,Bochdalek hernia forms 81.4% of all congenital diaphragmatic hernia, the peak incidence at presentation was in the neonatal period (80,2%) of patients. The chest roentgenographic appearance was diagnostic in 87.5% of the patients with Bochdalek while Morgagni hernia in 62.5% of patients was diagnostic. Morgagni hernia constitutes 13.6% of the congenital variety, commonly to the right side (87.5% of patients ).The incidence of presentation beyond the neonatal period was 50% of cases . Absence of hemidiaphragm was found in 5% of the congenital variety , the chest x-ray was diagnostic in all patients.
Conclusion: The chest roentgenograph (frontal view) is a very helpful diagnostic tool for the diaphragmatic hernia with a high diagnostic accuracy (73.7%).

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