Editing Diaphragmatic hernia (section)

== '''Management''' ==

* Congenital Bochdalek hernia
** Delayed operative approach - deferred until cardiorespiratory stabilisation is achieved, which can take weeks
** Reduction of herniated contents and closure of the diaphragmatic defect
** Most infants go home off oxygen
* Congenital Morgagni hernia
** Better outcomes due to absence of respiratory defects seen with Bochdalek hernias
** Repair is indicated in all patients due to risk of strangulation
*** Emergency: upper midline laparotomy
*** Elective: generally laparoscopic repair
** Resect sac then primary repair with non-absorbable horizontal mattress sutures. Diaphragm secured to the posterior part of the sternum and to the posterior rectus sheath.
*** Mesh only if needed due to large defects and weak tissue - some sort of synthetic mesh, will need to be coated
** Recurrence is rare and results are excellent


For operative technique, see topic under 'trauma'
[[Category:Thoracics]]