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Bilateral congenital diaphragmatic hernia.
Holly L Neville1, Tom Jaksic, Jay M Wilson
1Department of Surgery, University of Texas-Houston Medical School, Houston, TX 77030, USA.
Journal of Pediatric Surgery
|March 13, 2003
Summary
Bilateral congenital diaphragmatic hernia (CDH) is rare and associated with high mortality. Infants with bilateral CDH often have other anomalies, complicating management and requiring prompt evaluation.
Area of Science:
- Neonatal surgery
- Pediatric surgery
- Congenital abnormalities
Background:
- Congenital diaphragmatic hernia (CDH) affects approximately 1 in 2,450 live births.
- Bilateral CDH is an extremely rare form of CDH, presenting unique management challenges for neonatologists and surgeons.
Purpose of the Study:
- To detail the management and outcomes of infants diagnosed with bilateral congenital diaphragmatic hernia.
- To analyze the characteristics and survival rates of bilateral CDH cases.
Main Methods:
- Retrospective review of liveborn patients with CDH between 1995 and 2001 from an 83-hospital database.
- Analysis of data from 17 patients with bilateral CDH, including demographics, associated anomalies, and treatment outcomes.
- Statistical analysis using the Chi-squared test to compare outcomes.
Main Results:
- Bilateral CDH represented 0.9% of CDH cases (17 out of 1833).
- A high mortality rate of 65% was observed in bilateral CDH cases, significantly higher than the 33% in unilateral CDH (P=0.01).
- Seventy percent of bilateral CDH patients had other major anomalies, including cardiac and chromosomal abnormalities.
Conclusions:
- Infants with bilateral congenital diaphragmatic hernia face significant management difficulties and a high mortality rate.
- The frequent association of bilateral CDH with other anomalies necessitates thorough evaluation for additional abnormalities.