Diaphragm defect that allows abdominal organs to move into chest cavity.Encyclopedia Entry for Diaphragmatic Hernia :Diaphragmatic hernia repair - congenital. Before this surgery, nearly all infants need a breathing device to improve their oxygen levels. The surgery is done while your child is under general anesthesia (asleep and not able to feel pain). The surgeon makes a cut (incision) in the belly under the upper ribs. This allows the organs in the area to be reached. The surgeon gently pulls these organs down into place through the opening in the diaphragm and into the abdominal cavity. The surgeon repairs the hole in the diaphragm. If the hole is small, it may be repaired with stitches. In most cases, a piece of plastic patch is used to cover the hole.The diaphragm is a muscle. It is important for breathing. It separates the chest cavity (where the heart and lungs are) from the belly area. In a child born with a diaphragmatic hernia, the diaphragm muscle is not completely formed. So, organs from the belly (stomach, spleen, liver, and intestines) may go up into the chest cavity where the lungs are. This prevents the lungs from growing normally. The lungs stay too small for babies to breathe on their own when they are born. A diaphragmatic hernia can be life threatening. Surgery to repair it must be done in the first few days or weeks of a child's life.Risks for this surgery include: Breathing problems , which may be severe Bleeding Collapsed lung Lung problems that do not go away Infection Reactions to medicines.Infants with a diaphragmatic hernia are admitted to a neonatal intensive care unit (NICU). It may be days or weeks before the baby is stable enough for surgery. In the NICU, your baby will probably need a breathing machine (mechanical ventilator) before the surgery. This helps the baby breathe. If your child is very sick, a heart-lung bypass machine ( ECMO ) may be needed to do the work of the heart and lungs. Before surgery, your baby will have x-rays and regular blood tests to see how well the lungs are working. A light sensor (called a pulse oximeter) is taped to baby's skin to monitor the oxygen level in the blood. Your baby may be given medicines to control blood pressure and keep them comfortable. Your baby will have tubes placed: From the mouth or nose to the stomach to keep air out of the stomach In an artery to monitor blood pressure In a vein to deliver nutrients and medicines.Your baby will be on a breathing machine after the surgery and will stay in the hospital for several weeks. Once taken off the breathing machine, your baby may still need oxygen and some medicine for a while. Feedings will start after your baby's bowels start working. Feedings are usually given through a small, soft feeding tube from the mouth or nose into the stomach or small intestine until your baby can take milk by mouth. Most infants with diaphragmatic hernias have reflux when they eat. This means the food or acid in their stomach moves up into their esophagus, the tube that leads from the throat to the stomach. This can be uncomfortable for your baby. It also leads to frequent spitting up, vomiting, and pneumonia, which makes feedings more difficult once your baby is taking food by mouth. The nurses and feeding specialists will teach you ways to hold and feed your baby to prevent reflux. Some babies need to be on a feeding tube for a long time to get enough food to grow.The outcome of this surgery depends on how well your baby's lungs have developed. Some babies have other medical problems, especially with the heart, brain, muscles, and joints, which may affect how well the baby does. Often, the outlook is good for infants who have well-developed lung tissue and no other problems. Most babies who are born with a diaphragmatic hernia are very ill and will stay in the hospital for a long time. With advances in medicine, the outlook for these infants is improving. All babies who have had diaphragmatic hernia repairs will need to be watched closely to make sure the hole in their diaphragm does not open up again as they grow. Babies who had a large opening or defect in the diaphragm, or who had more problems with their lungs after birth, may have lung disease after they leave the hospital. They may need oxygen, medicines, and a feeding tube for months or years. Some babies will have problems crawling, walking, talking, and eating. They will need to see physical or occupational therapists to help them develop muscles and strength.Diaphragmatic hernia - surgery.Bringing your child to visit a very ill sibling Surgical wound care - open.Diaphragmatic hernia repair - series Diaphragmatic hernia repair - series.Carlo WA, Ambalavanan N. Respiratory tract disorders.Encyclopedia Entry for Diaphragmatic Hernia :Diaphragmatic hernia. A diaphragmatic hernia is a rare defect. It occurs while the baby is developing in the womb. Because the diaphragm is not fully developed, organs, such as the stomach, small intestine, spleen, part of the liver, and the kidney, may take up part of the chest cavity. CDH most often involves only one side of the diaphragm. It is more common on the left side. Often, the lung tissue and blood vessels in the area do not develop normally either. It is not clear if the diaphragmatic hernia causes the underdeveloped lung tissue and blood vessels, or the other way around. 40% of babies with this condition have other problems as well. Having a parent or sibling with the condition increases the risk.Severe breathing problems almost always develop shortly after the baby is born. This is due in part to poor movement of the diaphragm muscle and crowding of the lung tissue. Problems with breathing and oxygen levels are often due to underdeveloped lung tissue and blood vessels as well. Other symptoms include: Bluish colored skin due to lack of oxygen Rapid breathing (tachypnea) Fast heart rate (tachycardia).Fetal ultrasound may show abdominal organs in the chest cavity. The pregnant woman may have a large amount of amniotic fluid. An exam of the infant shows: Irregular chest movements Lack of breath sounds on side with the hernia Bowel sounds that are heard in the chest Abdomen that looks less protuberant than a normal newborn's and feels less full when touched A chest x-ray may show abdominal organs in the chest cavity.A diaphragmatic hernia repair is an emergency that requires surgery. Surgery is done to place the abdominal organs into the proper position and repair the opening in the diaphragm. The infant will need breathing support during the recovery period. Some infants are placed on a heart/lung bypass machine to help deliver enough oxygen to the body. If a diaphragmatic hernia is diagnosed early during pregnancy (before 24 to 28 weeks), fetal surgery may be an option in some situations.The outcome of surgery depends on how well the baby's lungs have developed. It also depends on whether there are any other congenital problems. Most often the outlook is good for infants who have a sufficient amount of working lung tissue and have no other problems. Medical advances have made it possible for over half of infants with this condition to survive. The babies survived will often have ongoing challenges with breathing, feeding, and growth.Complications may include: Lung infections Other congenital problems.Go to the emergency room or call the local emergency number (such as 911). A diaphragmatic hernia is a surgical emergency.There is no known prevention. Couples with a family history of this problem may want to seek genetic counseling.Hernia - diaphragmatic; Congenital hernia of the diaphragm (CDH).Infant diaphragmatic hernia Infant diaphragmatic hernia Diaphragmatic hernia repair - series Diaphragmatic hernia repair - series.Carlo WA, Ambalavanan N. Respiratory tract disorders.