Congenital Diaphragmatic Hernia

Caused by failed closure of the pleuroperitoneal canal, which is the last portion of the diaphragm to close. It therefore usually occurs on the left side, posterior and laterally. Presentation is as respiratory distress at birth or several hours thereafter and is due to pulmonary hypoplasia, pulmonary artery hypertension, and/or persistence of fetal circulation. Radiographically it may be seen as air-filled bowel within the chest cavity. Initial treatment is stabilization and ventilation/oxygenation by ventilator support or by ECMO. Surgical repair involves a two layered primary closure of the defect. Occasionally, a prosthetic patch may be required.

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