[Skip to Content]
Sign In
Individual Sign In
Create an Account
Institutional Sign In
OpenAthens Shibboleth
[Skip to Content Landing]
Article
October 1979

Congenital Diaphragmatic HerniasEleven Years' Experience

Author Affiliations

From the Department of Surgery, Childrens Hospital of Los Angeles (Drs Mishalany and Woolley), and St Marianna University, Kawasaki, Japan (Dr Nakada).

Arch Surg. 1979;114(10):1118-1123. doi:10.1001/archsurg.1979.01370340024003
Abstract

• Fifty-five patients with congenital diaphragmatic hernias (1966 to 1976) were studied and compared to 65 similar patients reported previously (1953 to 1963). The mortality was found to be the same in the two groups despite the fact that in the current series, patients were diagnosed and operated on at a younger age. Initial uncorrected pH value was found to be of prognostic importance. All babies whose initial uncorrected pH was greater than 7.0 survived and almost all those whose pH was less than 7.0 died, with the group in-between having a 50% chance of survival. Earlier operation and correction of acidosis did not substantially improve the chance of survival. Hypoplasia of the lungs and major cardiovascular anomalies contributed to death in a number of patients. Pulmonary hypertension causing a right-to-left shunt was responsible for the deaths of others and, therefore, the use of vasodilator drugs deserves further evaluation.

(Arch Surg 114:1118-1123, 1979)

References
1.
Collins DL, Pomerance JJ, Travis KW, et al:  A new approach to congenital posterolateral diaphragmatic hernia . J Pediatr Surg 12:149-156, 1977.Article
2.
Rudolph AM:  The changes in circulation after birth . Circulation 41:343-359, 1970.Article
3.
Boxin-Ochoa J, Peguero G, Seijo G, et al:  Acid-base balance and blood gases in prognosis and therapy of congenital diaphragmatic hernia . J Pediatr Surg 9:49-57, 1974.Article
4.
Kiesewetter WB, Gutiewez IZ, Siebor WK:  Diaphragmatic hernia in infants under one year of age . Arch Surg 83:561-572, 1961.Article
5.
Dibbins AW, Wiener A:  Mortality from neonatal diaphragmatic hernia . J Pediatr Surg 9:653-662, 1974.Article
6.
Lewis MAH, Young DG:  Ventilatory problems with congenital diaphragmatic hernia . Anesthesia 24:571-580, 1969.Article
7.
Snyder WH, Greany EM:  Congenital diaphragmatic hernia: 77 consecutive cases . Surgery 57:576-588, 1965.
8.
Allen MS, Thomson SA:  Congenital diaphragmatic hernia in children under one year of age: A 24-year review . J Pediatr Surg 1:157-161, 1966.Article
9.
Livaditis A, Nordstrand A:  Congenital posterolateral diaphragmatic hernia in infants . Scand J Thorac Cardiovasc Surg 5:67-73, 1971.Article
10.
Woolley MM:  Delayed appearance of a left posterolateral diaphragmatic hernia resulting in significant small bowel necrosis . J Pediatr Surg 12:673-674, 1977.Article
11.
Coppoletta JM, Wolback SG:  Body length and organ weights of infants and children: A study of the body length, normal weights of the more important vital organs of the body between birth and 12 years of age . Am J Pathol 9:55-70, 1933.
12.
Gruenwald P, Minh NH:  Evaluation of body and organ weights in perinatal pathology: Normal standards derived from autopsies . Am J Clin Pathol 34:247-253, 1960.
13.
De Lorimer AA:  Morphometric and bronchial changes in human pulmonary hypoplasia , in Proceedings of the Pediatric Surgical Congress . Melbourne, Royal Childrens Hospital, 1970, vol 2, pp 367-372.
14.
Areechon W, Reid L:  Hypoplasia of lung with congenital diaphragmatic hernia . Br Med J 1:230-233, 1963.Article
15.
Greenwood RD, Rosenthal A, Nadas AS:  Cardiovascular abnormalities associated with congenital diaphragmatic hernia . Pediatrics 67:92-107, 1976.
×