Diaphragmatic Hernia Overview
A diaphragmatic hernia is an abnormal opening in the diaphragm, a dome-shaped muscle that separates the chest (thoracic) cavity from the abdominal cavity. The opening can allow some of the abdominal organs, such as the stomach, intestines and liver, to move into the thoracic cavity.
A diaphragmatic hernia may be present at birth (congenital) or acquired during life (traumatic). Both conditions are relatively rare.
Diaphragmatic Hernia Causes and Risk Factors
A congenital diaphragmatic hernia occurs when the diaphragm does not fully form during fetal development, leaving an opening between the thoracic and abdominal cavities. An acquired diaphragmatic hernia is caused by trauma, such as a blunt or penetrating injury to the abdomen or chest.
Diaphragmatic hernia risk factors include:
- Family history – Individuals who have a parent or sibling with a congenital diaphragmatic hernia are at heightened risk.
- Trauma – The diaphragm can tear due to physical strain, such as a bout of heavy lifting or severe vomiting, or a direct blow to the chest or abdomen sustained in a fall or collision.
- Surgery – A surgical procedure involving the diaphragm, esophagus or stomach could increase the risk of developing a diaphragmatic hernia, especially if complications arise during recovery.
Diaphragmatic Hernia Signs and Symptoms
The first sign of a diaphragmatic hernia may be respiratory distress. Difficulty breathing can occur as some of the abdominal organs protrude into the chest cavity, compressing the lungs and limiting their ability to expand properly.
What Does a Diaphragmatic Hernia Feel Like?
Symptoms of an acquired diaphragmatic hernia may develop suddenly after trauma and can include shortness of breath, chest pain and abdominal pain.
What Does Diaphragmatic Hernia Look Like?
A congenital diaphragmatic hernia may be visibly apparent immediately after birth. The signs can include rapid breathing, a bluish tint to the skin due to lack of oxygen (cyanosis) and an abnormally shaped chest.
Diaphragmatic Hernia Diagnosis
The diagnostic process for a diaphragmatic hernia usually begins with a physical examination. A physician will listen to the chest with a stethoscope to check for abnormal breathing and bowel sounds in the chest, which could indicate the presence of abdominal organs in the thoracic cavity.
If a diaphragmatic hernia is suspected, the physician will typically order a chest X-ray, which may reveal displaced abdominal organs and any associated lung compression. If further detail is needed to confirm the diagnosis, the physician may order additional imaging studies, such as ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) scans. Ultrasound scans can be particularly useful for diagnosing newborns and infants.
If the patient is experiencing respiratory distress, the physician may order a blood gas analysis to assess the severity of the oxygenation and ventilation issues.
Diaphragmatic Hernia Treatment
Treatment for a diaphragmatic hernia can vary depending on its type and severity and the patient’s overall health. In most cases, the primary treatment is surgical repair, which involves repositioning the herniated organs back into the abdominal cavity and closing the opening in the diaphragm. This procedure may be performed using open or minimally invasive techniques.
After surgery, ongoing monitoring and follow-up care are essential to ensure proper healing and to address any complications that may arise. Some patients may need specialized nutritional support during recovery.
Benefit From World-Class Care at TGH
The multidisciplinary team in Tampa General Hospital’s renowned Digestive Diseases Institute offers the latest diagnostic, treatment and supportive care options for congenital and acquired diaphragmatic hernias. If you would like a referral to a physician in TGH’s GERD and Esophageal Surgery Center, please call 1-800-822-3627 or use our online Physician Finder.