Prognosis of a diaphragmatic hernia | The diaphragmatic hernia

Prognosis of a diaphragmatic hernia

The prognosis of a diaphragmatic hernia is usually very good. Thus, in many hernias which do not cause any symptoms no therapy is necessary. The success of the operation is assessed as very good, although most patients are symptom-free after the operation.

A more unfavorable prognosis exists for congenital diaphragmatic hernias. The prognosis of these hernias is mainly determined by the restriction of lung function. In the case of a large hernia and associated severe restriction of lung development, the prognosis is unfavorable.

As a rule, the affected children have to undergo pediatric surgery immediately after birth. However, since the limitation is often limited, the operation is successful in many cases. The survival rate varies from clinic to clinic and is up to 90% of the operated children.

For babies with congenital diaphragmatic hernia, the survival rate depends strongly on various factors. The severity of the hernia plays a major role, i.e. the exact location, size and which organs have slipped into the thorax. The larger the contents of the hernia sac, the less space the lung has to develop in the womb (so-called pulmonary hypoplasia).

Once the child is born, the underdeveloped lung cannot supply the body with sufficient oxygen and the newborn baby has difficulty breathing. An operation is always necessary to close the defect. Children recover from this in 60-80% of cases, depending on the specialization of the pediatric clinic.

Without surgical treatment of an acquired diaphragmatic hernia the squeezed organs, especially the stomach and heart, are damaged. The stomach lining is permanently irritated by the constriction, and ulcers may occur. The heart also suffers from displacement by the stomach, which can manifest itself in rapid heart rate, cardiac arrhythmia and symptoms similar to heart attacks (so-called Roemheld syndrome).

The esophagus, which is permanently attacked by gastric acid, can also become inflamed. In the worst case, the inflammation of the esophagus can even degenerate into a carcinoma of the esophagus. The late consequences after surgery are usually the same, regardless of whether the diaphragmatic hernia is congenital, acquired or traumatically caused.

The artificial closure of the diaphragmatic hernia that was artificially created by surgery can reopen and result in a new operation. Such a recurrence is quite frequent. Another classical consequence after surgery is a narrowing at the transition from esophagus to stomach.

This can manifest itself by the feeling that the bite is literally stuck in the throat (or in the chest, i.e. in front of the entrance to the stomach). Another phenomenon of the new constriction is the so-called gas-bloat syndrome. Patients can no longer belch to get rid of excess gas in the stomach. Many patients find this quite unpleasant, as the gas collects in the stomach.