Wednesday, June 22, 2005

Answer to the image quiz

Answer-Congenital Diaphragmatic Hernia
Winner-Jen SN (email sumerdoc-AT-yahoo-dot-com with your mailing address)
About Diaphragmatic Hernia-
The topic of congenital diaphragmatic hernia (CDH) frequently appears in the medical literature since its first description in the early 18th century. Initial theories about the pathophysiology of this condition centered on the presence of the herniated viscera within the chest and the need for its prompt removal. In 1946, Gross reported the first successful repair of a neonatal diaphragmatic hernia in the first 24 hours of life. The medical literature for the next decade addressed CDH as a surgical problem and discussed various technical aspects of surgical repair, including techniques required to close large defects. In the 1960s, however, Areechon and Reid observed that the high mortality rate of CDH was related to the degree of pulmonary hypoplasia at birth. Over the past 20 years, pulmonary hypertension and pulmonary hypoplasia have been recognized as the 2 cornerstones of the pathophysiology of CDH. In recent years, evidence suggests that dysfunction of the surfactant system as well as cardiac maldevelopment may further complicate the pathophysiology of CDH.
The 3 basic types of CDH are the posterolateral Bochdalek hernia (occurring at approximately 6 weeks' gestation), the anterior Morgagni hernia, and the hiatus hernia. The left-sided Bochdalek hernia occurs in approximately 90% of cases. Left-sided hernias allow herniation of both small and large bowel as well as intra-abdominal solid organs into the thoracic cavity. In right-sided hernias, only the liver and a portion of the large bowel tend to herniate. Bilateral hernias are uncommon and usually fatal.
Further Reading- Article on eMedicine

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