Diagnostic procedures for diaphragmatic hernia
A congenital diaphragmatic hernia is usually diagnosed during control examinations before the birth of the child. Ultrasound examinations can determine relatively precisely to what extent the hernia influences the development of the child and which measures should be carried out as a priority immediately after birth. In the case of acquired diaphragmatic hernias, the anamnesis is the first step in diagnosis.
The described symptoms can substantiate the suspicion of a diaphragmatic hernia and help determine the next diagnostic steps. However, in order to be able to diagnose a diaphragmatic hernia with certainty, an imaging examination is usually performed. With the help of an ultrasound and especially an x-ray examination a diaphragmatic hernia can often be diagnosed safely.
During the x-ray examination a certain contrast medium must be taken to ensure that the critical areas can be imaged reliably. In the X-ray image, the intestinal or gastric sections that are located above the diaphragm can be well visualized. The localization of the hernia is also clearly visible in the X-ray image. MRI examinations are also well suited, although this is usually only used for special problems due to the effort and costs involved.
Frequency distribution
A congenital diaphragmatic hernia occurs in about one in 2500 children. Acquired diaphragmatic hernias usually occur on the left side and often after serious accidents and injuries, with about 10,000 diaphragmatic hernias occurring throughout Germany every year.
Therapy of a diaphragmatic hernia
A diaphragmatic hernia is often treated by means of a surgical procedure. This is especially the case with congenital diaphragmatic hernias. Acquired hernias, which occur during life, will be operated if symptoms occur and cannot be treated with conservative methods.
In many cases, surgery must be performed to prevent intestinal constriction, as this can lead to serious complications. If complications already exist and a deficient blood supply to individual sections of the intestine is possible or imminent, surgery should be performed as soon as possible.Depending on the location and cause of the diaphragmatic hernia, different surgical techniques must be used. In most cases it is a so-called hiatus hernia, where the stomach passes through the diaphragm.
This is brought back into the optimal position during the operation. To prevent the stomach from moving up again, the diaphragmatic gap is reduced in size and stabilized with a certain surgical technique. To prevent the stomach from moving up again, it is sutured to the underside of the diaphragm.
Another possibility is to wrap the stomach around the esophagus below the diaphragm and fix it either to itself or to the esophagus. This technique is usually used when heartburn and reflux are the main symptoms. Congenital diaphragmatic defects are closed with a net if necessary and sutured tighter. Are you about to have an operation and you would like to find out more about it?
