Clinical features

In the current era, diaphragmatic hernia is often diagnosed during prenatal ultrasound scanning. The advantage of prenatal diagnosis is that delivery can be planned to take place in a unit with appropriate pediatric surgical and intensive care facilities. For those infants who avoid prenatal diagnosis, for whatever reason, the clinical features depend on the volume of abdominal contents within the thoracic cavity and the degree of lung hypoplasia. In the most severe cases, there will be severe respiratory distress and cyanosis from shortly after birth. At the other end of the spectrum are infants who have minimal if any respiratory symptoms or signs and in whom intestinal loops are noted to be in the abdomen on chest X-ray (Figure 2.7).

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