Diaphragmatic Hernias

What are diaphragmatic hernias?

Diaphragmatic hernias occur when there is a weakness, or opening, in the diaphragm, the sheet-like muscle that sits below the lungs and normally separates the thoracic cavity (where the lungs and heart are) from the abdominal cavity. If the diaphragm has an opening, contents of the abdomen – organs such as the stomach, intestines, spleen, or liver – can break through the opening and appear in the thoracic cavity, which is a surgical emergency. 

Diaphragmatic hernias are often named after their location. A Morgagni hernia is located more towards the front, where the colon or omentum are most in danger of moving through the hernia into the thoracic cavity. In the case of a Bochdalek hernia, which is located closer to the back, the kidney is more at risk. 

What are the causes of diaphragmatic hernias?

Typically, diaphragmatic hernias are present at birth as a developmental defect but can occur in adulthood due to trauma or injury. When congenital, diaphragmatic hernias are associated with genetic conditions such as congenital heart defects and Down syndrome.

What are the symptoms of diaphragmatic hernias?

Some diaphragmatic hernias can be asymptomatic. When symptoms do occur, they include:

  • Difficulty breathing
  • Rapid breathing
  • Racing heart rate
  • Reduced appetite

How are diaphragmatic hernias diagnosed?

Diaphragmatic hernias can be seen on routine imaging, such as x-ray, ultrasound, MRI, and CT scan. Tests measuring blood gases helps further assess how well the lungs are functioning. 

How is a diaphragmatic hernia treated?

Surgical repair of the hernia is the most common treatment, where the hernia is closed with sutures to restore the integrity of the diaphragm and prevent abdominal organs from entering the thoracic cavity.