Diaphragmatic Hernia

A diaphragmatic hernia occurs when a hole or tear forms in the muscle between the chest and abdomen, the diaphragm. As a result, abdominal organs can push up into the chest. 

This kind of defect either develops when the diaphragm doesn't form correctly before birth or can result later in life after an injury. 

In this article, we will discuss the symptoms, diagnoses, and treatment options for diaphragmatic hernias.

Occurrence Of Diaphragmatic Hernias

There are two types of diaphragmatic hernia:

Congenital diaphragmatic hernia

Diaphragmatic hernia (CDH) happens when the diaphragm doesn't form properly before birth. This creates an opening in the diaphragm through which abdominal organs like the stomach, intestines, and liver can protrude.

It's not exactly known what causes CDH, but some experts think it's both genetic and environmental. Some studies have suggested that CDH may be caused by genetic mutations as well as by exposure to certain chemicals and toxins during pregnancy.

Acquired diaphragmatic hernia

In contrast to congenital diaphragmatic hernia, ADH can develop at any age due to injury or trauma.

Injuries such as blunt force trauma to the chest or penetrating wounds in the abdomen can cause a tear of the diaphragm. Additionally, ADH can occur as a complication of chronic obstructive pulmonary disease (COPD), a condition that weakens the diaphragm.

Symptoms of Diaphragmatic Hernia

An individual with a diaphragmatic hernia may experience different symptoms based on the size, location, and age of the hernia.

Symptoms of a diaphragmatic hernia in infants include:

• Rapid breathing
• Grunting or noisy breathing
• A bluish coloration of the skin (cyanosis)
• Abdominal discomfort
• Weight loss or slow growth

In adults, symptoms of a diaphragmatic hernia may include:

• Pain in the chest or abdomen
• Difficulty breathing
• A feeling of fullness in the chest or abdomen
• A lump or bulge 
• Nausea or vomiting
• Trouble swallowing

Diagnosis

Like the other types of hernias, a diaphragmatic hernia is also diagnosed after a detailed physical examination. A doctor may listen to the patient's breathing with a stethoscope while looking for physical signs of a hernia, such as a bulge in the chest or abdomen.

The following tests may also be used to diagnose a diaphragmatic hernia:

• X-ray: X-rays create images of internal structures, including bones, organs, and soft tissues. Hernias can be visualized with an X-ray by determining their location, size, and shape. Moreover, x-rays can help check for obstruction in the intestine, a common complication of hernias.

• Ultrasound: An ultrasound creates images of the internal organs and structures of the body by using high-frequency sound waves. Ultrasound is performed by placing a handheld transducer over the area of interest and emitting high-frequency sound waves. Transducers record echoes caused by reflected sound waves inside the body and use them to create images of the organs and structures. Ultrasounds may show protrusion of abdominal organs into the chest cavity if the diaphragm is torn or weak. The ultrasound can also show fluid or air in the chest, which could be a diaphragmatic hernia.

• CT scan: The CT scan provides detailed images of the internal structures of the body, specifically the chest and abdomen, which can help diagnose a diaphragmatic hernia. Furthermore, it displays the extent, size, and location of the herniation, as well as any complications that may occur such as lung compression, pleural effusion, or bowel obstruction.

• MRI: An MRI takes detailed images of the diaphragm and surrounding structures to diagnose diaphragmatic hernias. MRIs can reveal the location and size of hernias, as well as whether any surrounding organs or tissues are being compressed or displaced. Furthermore, MRI can also detect any associated complications.

There are some serious complications associated with a diaphragmatic hernia, such as bowel obstructions and strangulation. This is why prompt diagnosis and management are imperative. The doctor may also order additional tests to determine if other conditions may also be contributing to the symptoms of a diaphragmatic hernia.

Treatment Options

A diaphragmatic hernia either congenital or acquired usually requires urgent surgery and the surgery options depend on its type and location.

Open surgery is one common surgical procedure for diaphragmatic hernias, in which the organs are returned to their proper positions and the opening in the diaphragm is closed. Hernias in this method are typically fixed through either a thoracotomy (opening of the chest) or laparotomy (opening of the abdomen).

An alternative surgical method used to repair hernias is laparoscopy, which uses small incisions and specialized instruments to repair hernias. Compared to traditional surgery, this approach is less invasive and offers quicker recovery times.

In some rare cases, it is also possible for the diaphragmatic hernia to not cause symptoms. If your doctor decides that surgery is not necessary at this time, he or she may suggest that you make lifestyle changes like maintaining a healthy weight, avoiding heavy lifting, and avoiding straining during bowel movements in order to reduce the risk of complications or symptoms.

It is recommended that you consult a professional to learn more about your situation or contact Hernia Innovations where we provide a variety of hernia treatment options. Contact us today for an appointment by sending us a message or calling us at (925) 940-1020.