A neonate within 4 hours of bih presented with severe respiratory distress. He appears to be dyspneic, tachypneic, and cyanotic with severe retractions of the chest. On examination, grunting is present along with use of the accessory muscles. Neonate also appears to have scaphoid abdomen and increased chest wall diameter. There is evidence of shift of the point of maximal cardiac impulse from its original location to the right side. Chest x ray of the neonate Defect in development of which pa of the responsible structure is causing this condition of the baby?

This is a case of congenital diaphragmatic hernia (bochdalek or posterolateral hernia) Chest radiograph shows a stomach, nasogastric tube, and small bowel contents in the thoracic cavity, consistent with a CDH. Development of Diaphragm: PA A: Body wall: Peripheral muscular pa PA B: Oesophageal Mesentery: Crura PA C: Septum Transversum: Central Tendon. PA D: Pleuroperitoneal membrane: Small intermediate muscular pa. More common mechanism for the origin of diaphragmatic hernias occurs when muscle cells fail to populate a region of the pleuroperitoneal membranes. This results in a weakened area and subsequent herniation of abdominal organs into the thoracic cavity. The primary cause for the muscle deficiency appears to reside in fibroblasts in the pleuroperitoneal membranes These fibroblasts fail to provide the appropriate scaffolding and/or guidance cues for migrating myoblasts.