What are the symptoms of different types of congenital diaphragmatic hernia?

Congenital diaphragmatic hernia can be divided into three types. The first type is posterolateral hernia, also known as thoracoabdominal hiatal hernia; the second type is parasternal hernia; and the third type is hiatal hernia.

1. Thoracic and abdominal hiatal hernia: The main clinical manifestations in the neonatal period are acute symptoms of the respiratory, circulatory and digestive systems, but respiratory symptoms are the most prominent manifestations.

Symptoms such as difficulty breathing, shortness of breath, and cyanosis can begin after birth or within a few hours of birth.

Its severity depends on the size of the diaphragmatic defect, the amount of abdominal organs protruding into the chest , and lung hypoplasia.

Dyspnea and cyanosis may appear paroxysmal and variable, worsening with crying or eating, or may worsen suddenly and progressively.

The entry of abdominal organs into the chest not only compresses the lungs, but also distorts the pulmonary artery, thickens the artery wall, and reduces the cross-sectional area of ​​the vascular bed.

As a result, in addition to cyanosis, there are a series of symptoms such as shortness of breath, acidemia, hypoxia, hypothermia, low calcium, and low magnesium.

2. Hiatal hernia: Hiatal hernia is common in infants and young children, with diverse clinical manifestations. The medical history cannot be described and there are no typical clinical symptoms.

If parents don’t watch carefully, diagnosis and treatment are often delayed.

Vomiting is the most common symptom of full-term newborns, infants and older children, accounting for more than 80% to 95%, and can occur in the first week after birth.

In addition to vomiting coffee-like material, sick children with severe vomiting also experience vomiting blood, passing tarry stools and black stools. In most stool tests, occult blood is often positive.Because gastroesophageal reflux often occurs at night, it often causes aspiration.

Recurrent symptoms of respiratory infections .

in sliding hiatal hernia Reflux esophagitis gradually worsens. The inflammation has invaded the muscle layer and caused fibrosis of the lower end of the esophagus. As a result, not only the esophagus is shortened, the cardiac fundus herniates into the chest cavity, but also esophageal stenosis occurs.

Sometimes the junction of the esophagus and the stomach is still in the normal position of the abdominal cavity, and the fundus of the stomach herniates into the chest or torsion herniates onto the right side of the diaphragm.

Poor gastric exhaust causes retention gastritis , ulcers, and bleeding.

3. Congenital retrosternal hernia: Parasternal hernia has no specific clinical symptoms and is usually accompanied by paroxysmal dyspnea, shortness of breath, cyanosis, etc.

When the position, quietness and abdominal pressure are reduced, the above symptoms disappear or decrease.

of the chest If the hernia embeds into the digestive tract , symptoms of intestinal obstruction such as vomiting, bloating, and cessation of gas and defecation will occur.

Gastrointestinal bleeding sometimes occurs, leading to anemia, and herniation of the colon into the chest often causes upper abdominal discomfort.