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Pediatrics
Diagnosis
Chest
Congenital Lung Lesions
Congenital Diaphragmatic Hernia
Congenital Diaphragmatic Hernia
David Larson, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Congenital diaphragmatic hernia (CDH)

            • Definitions

              • Herniation of abdominal contents into chest via defect in diaphragm
                • Bochdalek hernia: Posterior hernia, most common type of CDH
                • Morgagni hernia: Anterior, much less common in neonates
                • Hiatal hernia: Also uncommon in neonates

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. McHugh K et al: Tracheomegaly: a complication of fetal endoscopic tracheal occlusion in the treatment of congenital diaphragmatic hernia. Pediatr Radiol. 40(5):674-80, 2010
                                      2. Kilian AK et al: Congenital diaphragmatic hernia: predictive value of MRI relative lung-to-head ratio compared with MRI fetal lung volume and sonographic lung-to-head ratio. AJR Am J Roentgenol. 192(1):153-8, 2009
                                      3. Taylor GA et al: Imaging of congenital diaphragmatic hernias. Pediatr Radiol. 39(1):1-16, 2009
                                      4. Büsing KA et al: Reliability and validity of MR image lung volume measurement in fetuses with congenital diaphragmatic hernia and in vitro lung models. Radiology. 246(2):553-61, 2008
                                      5. Datin-Dorriere V et al: Prenatal prognosis in isolated congenital diaphragmatic hernia. Am J Obstet Gynecol. 198(1):80, 2008
                                      6. Barnewolt CE et al: Percent predicted lung volumes as measured on fetal magnetic resonance imaging: a useful biometric parameter for risk stratification in congenital diaphragmatic hernia. J Pediatr Surg. 42(1):193-7, 2007
                                      7. Holt PD et al: Newborns with diaphragmatic hernia: initial chest radiography does not have a role in predicting clinical outcome. Pediatr Radiol. 34(6):462-4, 2004
                                      8. Johnson AM et al: Congenital anomalies of the fetal/neonatal chest. Semin Roentgenol. 39(2):197-214, 2004
                                      9. Keller TM et al: MR assessment of fetal lung development using lung volumes and signal intensities. Eur Radiol. 14(6):984-9, 2004
                                      10. Veyrac C et al: MRI of fetal GI tract abnormalities. Abdom Imaging. 29(4):411-20, 2004
                                      11. Matsuoka S et al: Comparison of magnetic resonance imaging and ultrasonography in the prenatal diagnosis of congenital thoracic abnormalities. Fetal Diagn Ther. 18(6):447-53, 2003
                                      12. Cohen MS et al: Influence of congenital heart disease on survival in children with congenital diaphragmatic hernia. J Pediatr. 141(1):25-30, 2002
                                      13. Sakurai M et al: Congenital diaphragmatic hernia in neonates: variations in umbilical catheter and enteric tube position. Radiology. 216(1):112-6, 2000
                                      14. Donnelly LF et al: Correlation between findings on chest radiography and survival in neonates with congenital diaphragmatic hernia. AJR Am J Roentgenol. 173(6):1589-93, 1999
                                      15. Clark RH et al: Current surgical management of congenital diaphragmatic hernia: a report from the Congenital Diaphragmatic Hernia Study Group. J Pediatr Surg. 33(7):1004-9, 1998
                                      16. Keshen TH et al: Does extracorporeal membrane oxygenation benefit neonates with congenital diaphragmatic hernia? Application of a predictive equation. J Pediatr Surg. 32(6):818-22, 1997
                                      17. Guibaud L et al: Fetal congenital diaphragmatic hernia: accuracy of sonography in the diagnosis and prediction of the outcome after birth. AJR Am J Roentgenol. 166(5):1195-202, 1996
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Congenital diaphragmatic hernia (CDH)

                                                • Definitions

                                                  • Herniation of abdominal contents into chest via defect in diaphragm
                                                    • Bochdalek hernia: Posterior hernia, most common type of CDH
                                                    • Morgagni hernia: Anterior, much less common in neonates
                                                    • Hiatal hernia: Also uncommon in neonates

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Ultrasonographic Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. McHugh K et al: Tracheomegaly: a complication of fetal endoscopic tracheal occlusion in the treatment of congenital diaphragmatic hernia. Pediatr Radiol. 40(5):674-80, 2010
                                                                          2. Kilian AK et al: Congenital diaphragmatic hernia: predictive value of MRI relative lung-to-head ratio compared with MRI fetal lung volume and sonographic lung-to-head ratio. AJR Am J Roentgenol. 192(1):153-8, 2009
                                                                          3. Taylor GA et al: Imaging of congenital diaphragmatic hernias. Pediatr Radiol. 39(1):1-16, 2009
                                                                          4. Büsing KA et al: Reliability and validity of MR image lung volume measurement in fetuses with congenital diaphragmatic hernia and in vitro lung models. Radiology. 246(2):553-61, 2008
                                                                          5. Datin-Dorriere V et al: Prenatal prognosis in isolated congenital diaphragmatic hernia. Am J Obstet Gynecol. 198(1):80, 2008
                                                                          6. Barnewolt CE et al: Percent predicted lung volumes as measured on fetal magnetic resonance imaging: a useful biometric parameter for risk stratification in congenital diaphragmatic hernia. J Pediatr Surg. 42(1):193-7, 2007
                                                                          7. Holt PD et al: Newborns with diaphragmatic hernia: initial chest radiography does not have a role in predicting clinical outcome. Pediatr Radiol. 34(6):462-4, 2004
                                                                          8. Johnson AM et al: Congenital anomalies of the fetal/neonatal chest. Semin Roentgenol. 39(2):197-214, 2004
                                                                          9. Keller TM et al: MR assessment of fetal lung development using lung volumes and signal intensities. Eur Radiol. 14(6):984-9, 2004
                                                                          10. Veyrac C et al: MRI of fetal GI tract abnormalities. Abdom Imaging. 29(4):411-20, 2004
                                                                          11. Matsuoka S et al: Comparison of magnetic resonance imaging and ultrasonography in the prenatal diagnosis of congenital thoracic abnormalities. Fetal Diagn Ther. 18(6):447-53, 2003
                                                                          12. Cohen MS et al: Influence of congenital heart disease on survival in children with congenital diaphragmatic hernia. J Pediatr. 141(1):25-30, 2002
                                                                          13. Sakurai M et al: Congenital diaphragmatic hernia in neonates: variations in umbilical catheter and enteric tube position. Radiology. 216(1):112-6, 2000
                                                                          14. Donnelly LF et al: Correlation between findings on chest radiography and survival in neonates with congenital diaphragmatic hernia. AJR Am J Roentgenol. 173(6):1589-93, 1999
                                                                          15. Clark RH et al: Current surgical management of congenital diaphragmatic hernia: a report from the Congenital Diaphragmatic Hernia Study Group. J Pediatr Surg. 33(7):1004-9, 1998
                                                                          16. Keshen TH et al: Does extracorporeal membrane oxygenation benefit neonates with congenital diaphragmatic hernia? Application of a predictive equation. J Pediatr Surg. 32(6):818-22, 1997
                                                                          17. Guibaud L et al: Fetal congenital diaphragmatic hernia: accuracy of sonography in the diagnosis and prediction of the outcome after birth. AJR Am J Roentgenol. 166(5):1195-202, 1996