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. 1994 Feb;53(2):101-5.

Congenital diaphragmatic hernia

Y J Wang  1 , C S Chi, W T Chang, H C Chen, W J Shian
Affiliations
  • PMID: 8167984

Congenital diaphragmatic hernia

Y J Wang et al. Zhonghua Yi Xue Za Zhi (Taipei). 1994 Feb.

Abstract

Background: The management of congenital diaphragmatic hernia (CDH) remains a subject of controversy. With the objective to achieve a better future survival rate, clinical analysis of 14 cases during a 10-year period was done.

Methods: From 1983 to 1992, 14 cases with CDH were treated at Taichung Veterans General Hospital. The medical records of these patients were reviewed thoroughly. In the meantime, Mann-whitney U and Fisher's exact tests were used to analyze the factors predicting the outcomes.

Results: The overall mortality rate was 36%. Bochdalek hernia represented the most common defect in those patients who were operated upon (10/13, 77%). Ipsilateral pulmonary hypoplasia was present in five patients, four of whom died. Unilateral diaphragm agenesis was noted in two cases and both expired postoperatively. Initial arterial pH < 7.2, PaCO2 > 60 mmHg and early onset of symptoms may predict a poor outcome. There were no significant benefits from preoperative stabilization in those patients whose initial arterial pH values were lower than 7.2.

Conclusions: CDH remains a major challenge for pediatricians and pediatric surgeons. Further studies are needed to deal with this frustrating disorder.

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