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Related Concept Videos

Hiatal Hernia01:25

Hiatal Hernia

A hiatal hernia is the abnormal protrusion of the stomach or other abdominal organs through the esophageal hiatus of the diaphragm into the thoracic cavity.Normally, the gastroesophageal junction (GEJ) lies below the diaphragm and is supported by the phrenoesophageal membrane, the diaphragmatic crura, and connective tissues. Weakening of these structures—due to aging, congenital defects like a short esophagus, or increased intra-abdominal pressure from coughing, obesity, pregnancy, or heavy...
Pulmonary Cycle: Exhalation01:17

Pulmonary Cycle: Exhalation

In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
Pneumothorax-I01:26

Pneumothorax-I

A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Pneumothorax II: Pathophysiology01:08

Pneumothorax II: Pathophysiology

Pneumothorax means the presence of air in the pleural space — the thin potential gap between the visceral and parietal pleura. This condition disrupts the normal pressure balance that keeps the lungs inflated, leading to partial or complete collapse of the affected lung.Normal physiologyUnder normal conditions, the pleural space maintains a slightly negative intrapleural pressure, which keeps the lungs expanded against the chest wall. This negative pressure creates a delicate balance between...
Esophageal Perforation-I: Introduction01:22

Esophageal Perforation-I: Introduction

Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
Pneumothorax-II01:27

Pneumothorax-II

Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:

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Updated: Jul 10, 2026

Transuterine Fetal Tracheal Occlusion Model in Mice
06:31

Transuterine Fetal Tracheal Occlusion Model in Mice

Published on: February 5, 2021

Congenital diaphragmatic hernia.

Paul D Robinson1, Dominic A Fitzgerald

  • 1Department of Respiratory Medicine, The Children's Hospital at Westmead, University of Sydney, New South Wales, Westmead, Australia. paulr3@chw.edu.au

Paediatric Respiratory Reviews
|November 17, 2007
PubMed
Summary

Congenital diaphragmatic hernia (CDH) affects 1 in 2000 infants. Despite advances, high mortality and long-term infant morbidity persist, highlighting the need for better evidence-based management guidelines.

Area of Science:

  • Pediatric Surgery
  • Neonatal Medicine
  • Medical Genetics

Background:

  • Congenital diaphragmatic hernia (CDH) is a serious birth defect with an incidence of up to 1 in 2000 births.
  • Recent decades show increased antenatal diagnosis and understanding of CDH pathophysiology, alongside clinical care advancements like fetal surgery.
  • Despite these advances, evidence-based management guidelines are lacking due to a scarcity of randomized controlled trials.

Purpose of the Study:

  • To review the current state of congenital diaphragmatic hernia management.
  • To highlight the persistent challenges in reducing overall mortality and long-term infant morbidity.
  • To emphasize the need for robust clinical trial data to inform evidence-based guidelines.

Main Methods:

  • Review of recent literature on congenital diaphragmatic hernia diagnosis, pathophysiology, and treatment outcomes.

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Transuterine Fetal Tracheal Occlusion Model in Mice
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  • Analysis of survival rates and long-term morbidity in CDH patients.
  • Identification of gaps in evidence-based management strategies.

    • Main Results:

    • Overall mortality for congenital diaphragmatic hernia remains high at over 60%, including significant 'hidden mortality'.
    • Improved survival rates are observed only in a subset of infants reaching surgical repair.
    • Long-term morbidity in surviving infants is substantial, necessitating multidisciplinary follow-up.
    • Late presentation and misdiagnosis on initial chest X-ray contribute to morbidity in 10% of cases.

    Conclusions:

    • Congenital diaphragmatic hernia management requires further research to develop evidence-based guidelines.
    • Addressing both immediate mortality and long-term infant morbidity is crucial for improving outcomes.
    • Multidisciplinary, long-term follow-up is essential for surviving infants with CDH.