Many of us may not realize that a fetus or newborn baby can have a hernia. We tend to think of a hernia as a teenage or adult problem, but there are many types of hernias. A hernia is a bulging of an organ through an abnormal opening. One type of hernia in infants that is important to diagnose and treat as early as possible is a congenital diaphragmatic hernia (CDH). This type of hernia occurs during development and can occur in both males and females. CDH is often first diagnosed on screening fetal ultrasound examinations.
So, what is a CDH? It is caused by a small (or sometimes big) hole in the diaphragm, the musculature structure that separates your lungs from your abdomen and helps you to breath. The hole allows organs from the abdomen to move through the hole into the chest and to push the lung out of the way. The intestine is the most common organ that moves through that hole, but the stomach, liver and spleen can also herniate.
When a CDH is found on ultrasound, your doctor may order additional radiology examinations. Exams may include ultrasound and fetal MRI before birth in order to monitor how the hernia is affecting the normal development of the affected organs, especially the lung and intestines. In some cases, the hernia can be repaired in utero (before the infant is born). In other cases, the surgery may be safer or more effective to perform after the baby is born. Your doctor may order x-rays and/or a CT at this time to prepare for surgical repair. Repair of the hernia is performed by closing the hole in the diaphragm after the displaced organs are moved back to their appropriate positions in the abdomen.
Contributed by Dr. Deborah Brahee and edited by Michelle Gramke.