Pediatric Radiology > Chest > Respiratory Neonatal Distress > Surgical Respiratory Neonatal Distress - CDH


Surgical Respiratory Neonatal Distress

Congenital Diaphragmatic Hernia (CDH)


A defect in the diaphragm will result in herniation of abdominal contents into the thoracic cavity. The mass effect from the abdominal contents in the chest will lead to severe respiratory distress from pulmonary hypoplasia in both the ipsilateral and contralateral lung. The most common defect is in the posterior and lateral diaphragm. This is a Bochdalek hernia, which is more common on the left (75%). A Morgagni hernia is less common and is anterior and medial. Morgagni hernias present later in life and are more common on the right because the heart and pericardium will protect the left side. Congenital diaphragmatic hernia is frequently diagnosed on prenatal US. The postnatal CXR is confirmatory.



Postnatal CXR demonstrates a mass in the lower left chest with shift of the mediastinum. The presence of bowel gas (red arrow) indicates the mass is due to a diaphragmatic hernia. In this case, the stomach remains in the abdominal cavity as indicated by the position of the nasogastric tube (yellow arrow).

CXR demonstrates a mass in the left chest with shift of the mediastinum. Although no bowel gas is identified, the position of the nasogastric tube (red arrow) indicates the stomach is located in the thoracic cavity.





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