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Slovenska pediatrija 2022; 29: 59-65

https://doi.org/10.38031/slovpediatr-2022-2-01en

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Review article

DIAGNOSTIC IMAGING OF CONGENITAL DIAPHRAGMATIC HERNIA

Luka Pušnik
Medicinska fakulteta Univerze v Ljubljani, Ljubljana, Slovenija

Polona Pečlin
Klinični oddelek za perinatologijo, Ginekološka klinika Ljubljana, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

Domen Plut
Katedra za radiologijo, Medicinska fakulteta Univerze v Ljubljani, Ljubljana, Slovenija in Klinični inštitut za radiologijo, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

Abstract

Congenital diaphragmatic hernia is a relatively common abnormality in the development of the diaphragm. In more than half of the cases, the diagnosis is made during a routine ultrasound examination in the second trimester of pregnancy. Ultrasound is sufficient for the diagnosis when abdominal organs are found in the thoracic cavity. However, magnetic resonance enables a more accurate assessment of the size of the hernia, the contents of the hernial sac, the volume of each lung and the proportion of herniated liver, which are prognostic indicators of the course of the disease. Most of the remaining cases of undetected diaphragmatic hernias are usually discovered early after birth with X-ray imaging performed because of respiratory distress. Nevertheless, a small proportion of hernias that do not cause clinical symptoms or signs are discovered incidentally later in life. Due to the frequent recurrence of diaphragmatic hernias after surgery and many comorbidities, patients require careful and precise long-term monitoring.

Key words: congenital diaphragmatic hernia, ultrasonography, magnetic resonance imaging, radiography, prenatal diagnostics, postnatal diagnostics