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Diaphragmatic hernia 2(DIH2)

MedGen UID:
347411
Concept ID:
C1857284
Anatomical Abnormality
Synonym: DIH2
 
Monarch Initiative: MONDO:0009103
OMIM®: 222400

Definition

Congenital diaphragmatic hernia is a defect in the diaphragm. The diaphragm, which is composed of muscle and other fibrous tissue, separates the organs in the abdomen from those in the chest. Abnormal development of the diaphragm before birth leads to defects ranging from a thinned area in the diaphragm to its complete absence. An absent or partially formed diaphragm results in an abnormal opening (hernia) that allows the stomach and intestines to move into the chest cavity and crowd the heart and lungs. This crowding can lead to underdevelopment of the lungs (pulmonary hypoplasia), potentially resulting in life-threatening breathing difficulties that are apparent from birth.

Congenital diaphragmatic hernias are often classified by their position. A Bochdalek hernia is a defect in the side or back of the diaphragm. Between 80 and 90 percent of congenital diaphragmatic hernias are of this type. A Morgnani hernia is a defect involving the front part of the diaphragm. This type of congenital diaphragmatic hernia, which accounts for approximately 2 percent of cases, is less likely to cause severe symptoms at birth. Other types of congenital diaphragmatic hernia, such as those affecting the central region of the diaphragm, or those in which the diaphragm muscle is absent with only a thin membrane in its place, are rare.

In 5 to 10 percent of affected individuals, signs and symptoms of congenital diaphragmatic hernia appear later in life and may include breathing problems or abdominal pain from protrusion of the intestine into the chest cavity. In about 1 percent of cases, congenital diaphragmatic hernia has no symptoms; it may be detected incidentally when medical imaging is done for other reasons. [from MedlinePlus Genetics]

Clinical features

From HPO
Agenesis of the diaphragm
MedGen UID:
67455
Concept ID:
C0221360
Congenital Abnormality
Congenital lack, i.e., aplasia of the diaphragm.
Congenital diaphragmatic hernia
MedGen UID:
68625
Concept ID:
C0235833
Congenital Abnormality
The presence of a hernia of the diaphragm present at birth.

Professional guidelines

PubMed

Kinsella JP, Neish SR, Ivy DD, Shaffer E, Abman SH
J Pediatr 1993 Jul;123(1):103-8. doi: 10.1016/s0022-3476(05)81551-3. PMID: 8320602

Recent clinical studies

Etiology

Gien J, Palmer C, Liechty K, Kinsella JP
J Pediatr 2022 Apr;243:188-192. Epub 2021 Dec 18 doi: 10.1016/j.jpeds.2021.12.009. PMID: 34929245
Piro E, Schierz IAM, Serra G, Puccio G, Giuffrè M, Corsello G
Ital J Pediatr 2020 May 24;46(1):73. doi: 10.1186/s13052-020-00838-z. PMID: 32448339Free PMC Article
Greenberg-Wolff I, Uliel L, Goitein O, Shemesh J, Rozenman J, Di Segni E, Konen E
Isr Med Assoc J 2008 Nov;10(11):806-8. PMID: 19070293
Nandi B, Mungongo C, Lakhoo K
Pediatr Surg Int 2008 Aug;24(8):939-42. Epub 2008 Jun 14 doi: 10.1007/s00383-008-2177-x. PMID: 18553088
Zwischenberger JB, Nguyen TT, Upp JR Jr, Bush PE, Cox CS Jr, Delosh T, Broemling L
J Thorac Cardiovasc Surg 1994 Mar;107(3):838-48; discussion 848-9. PMID: 8127113

Diagnosis

Piro E, Schierz IAM, Serra G, Puccio G, Giuffrè M, Corsello G
Ital J Pediatr 2020 May 24;46(1):73. doi: 10.1186/s13052-020-00838-z. PMID: 32448339Free PMC Article
Nandi B, Mungongo C, Lakhoo K
Pediatr Surg Int 2008 Aug;24(8):939-42. Epub 2008 Jun 14 doi: 10.1007/s00383-008-2177-x. PMID: 18553088
Wilson JM, Bower LK, Thompson JE, Fauza DO, Fackler JC
J Pediatr Surg 1996 Aug;31(8):1116-22; discussion 1122-3. doi: 10.1016/s0022-3468(96)90099-8. PMID: 8863246
Kinsella JP, Neish SR, Ivy DD, Shaffer E, Abman SH
J Pediatr 1993 Jul;123(1):103-8. doi: 10.1016/s0022-3476(05)81551-3. PMID: 8320602
Morris CA, Palumbos JC, Carey JC
Am J Med Genet 1987 Jul;27(3):623-31. doi: 10.1002/ajmg.1320270315. PMID: 3631134

Therapy

Desai RK, Yildiz Atar H, Lakshminrusimha S, Ryan RM
J Perinatol 2024 Apr;44(4):478-487. Epub 2024 Mar 8 doi: 10.1038/s41372-024-01921-7. PMID: 38459371
Shimamura Y, Maisawa K, Okamoto N, Yamafuji K
Gen Thorac Cardiovasc Surg 2012 Jul;60(7):431-4. Epub 2012 May 8 doi: 10.1007/s11748-012-0017-3. PMID: 22566251
Wilson JM, Bower LK, Thompson JE, Fauza DO, Fackler JC
J Pediatr Surg 1996 Aug;31(8):1116-22; discussion 1122-3. doi: 10.1016/s0022-3468(96)90099-8. PMID: 8863246
Zwischenberger JB, Nguyen TT, Upp JR Jr, Bush PE, Cox CS Jr, Delosh T, Broemling L
J Thorac Cardiovasc Surg 1994 Mar;107(3):838-48; discussion 848-9. PMID: 8127113
Shamberger RC, Welch KJ
J Pediatr Surg 1988 Jul;23(7):615-22. doi: 10.1016/s0022-3468(88)80629-8. PMID: 3204460

Prognosis

Piro E, Schierz IAM, Serra G, Puccio G, Giuffrè M, Corsello G
Ital J Pediatr 2020 May 24;46(1):73. doi: 10.1186/s13052-020-00838-z. PMID: 32448339Free PMC Article
Wilson JM, Bower LK, Thompson JE, Fauza DO, Fackler JC
J Pediatr Surg 1996 Aug;31(8):1116-22; discussion 1122-3. doi: 10.1016/s0022-3468(96)90099-8. PMID: 8863246
Zwischenberger JB, Nguyen TT, Upp JR Jr, Bush PE, Cox CS Jr, Delosh T, Broemling L
J Thorac Cardiovasc Surg 1994 Mar;107(3):838-48; discussion 848-9. PMID: 8127113

Clinical prediction guides

Gien J, Palmer C, Liechty K, Kinsella JP
J Pediatr 2022 Apr;243:188-192. Epub 2021 Dec 18 doi: 10.1016/j.jpeds.2021.12.009. PMID: 34929245
Piro E, Schierz IAM, Serra G, Puccio G, Giuffrè M, Corsello G
Ital J Pediatr 2020 May 24;46(1):73. doi: 10.1186/s13052-020-00838-z. PMID: 32448339Free PMC Article
Morris CA, Palumbos JC, Carey JC
Am J Med Genet 1987 Jul;27(3):623-31. doi: 10.1002/ajmg.1320270315. PMID: 3631134

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