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Surgery General e41b5817

What is not true regarding Bochdalek hernia ?

A
Early respiratory distress leading to early diagnosis and treatment are good prognostic sign.
B
Stomach and transverse colon are commonest content to herniate
C
Diagnosed prenataly by ultrasound
D
Common on left posterior side
High-Yield Explanation
Ans is 'a' Early respiratory distress leading Neonates presenting with symptoms of respiratory distress within 24 hrs is a poor prognostic sign. The earlier the symptoms arise the worst is the prognosis. Congenital diaphragmatic hernia It is the herniation of abdominal contents into the thoracic cavity through the diaphragmatic defect The defect may be posterolateral (Bochdalek hernia) retrosternal (Morgagni hernia) at the esophageal hiatus (hiatal hernia) adjacent to the hiatus (paresophageal hernia) Although all these defects are congenital, the term congenital diaphragmatic hernia is generally used for Bochdalek hernia. Bochdalek hernia Most Bochdalek hernia are on the left side (-80%)and may rarely be bilateral. Compression of the lung results in pulmonary hypoplasia, involving both the lungs (ipsilateral > contralateral) Pulmonary vasculature is also abnormal leading to pulmonary hypeension. Thus the two main factors that affect morbidity and moality are pulmonary hypoplasia and pulmonary hypeension. The most frequent clinical presentation of CDH is respiratory distress due to severe hypoxemia. - The anteroposterior diameter of the chest may be large along with a scaphoid abdomen. The diagnosis of CDH can be made prenatally by ultrasound. The postnatal diagnosis is relatively straightforward because a plain chest radiograph demonstrates the gastric air bubbles or loops of bowel within the chest. There may also be a mediastinal shift away from the side of the hernia.

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