CONGENITAL DIAPHRAGMATIC HERNIA: NOT ONLY A NEONATAL DISEASE

Key words: Congenital diaphragmatic hernia, Aetiology, Diagnosis and therapy

Congenital diaphragmatic hernia (CDH) is a relatively common disease which depends on the passage of some abdominal organs into the chest cavity. Its incidence is of 1 in 3000 live births. CDH aetiology has not been yet fully established, but hypoplasia and vascular abnormalities of the lungs are the most common known effects of the trans-diaphragmatic herniation. Antenatal diagnosis is made in only half of the cases. Moreover, there is the possibility of a late-presenting form. Both these aspects explain why it is possible to run into CDH also in peripheral hospitals. It is therefore fundamental to remember few but important diagnostic and therapeutic tools for a correct initial management of CDH. Nowadays, a new therapeutic approach is the prenatal intervention based on fetal endoscopic tracheal occlusion. After birth, attention should be drawn on the avoidance of potentially injurious forms of ventilation and deferred surgical repair.