Diaphragmatic hernia in fetus
Author: doctor Derjushev A.N.
Diaphragmatic hernia is the movement of the abdominal cavity organs into the thoracic cavity, through a defect in the diaphragm or when there is a weak zone in it. In this case, the presence of a hernial sac, hernial portal and hernial contents is characteristic. And, if the hernial sac is absent - the hernia is called false.
All diaphragmatic hernias are divided into traumatic and non-traumatic hernias. The non-traumatic hernia, to which the diaphragmatic hernia of the fetus relates, is divided into false congenital hernia (defects) of the diaphragm, true hernia of the weak zones of the diaphragm, true hernias of atypical localizations, hernia of natural apertures of the diaphragm.
Diaphragmatic hernia in the fetus occurs as a result of the developmental defects of the diaphragm. Congenital hernias are divided into true hernias, which have a hernial sac and false ones, in which the abdominal organs through the through defect in the diaphragm are directly in contact with the lung and the heart. The frequency of occurrence of such hernias according to statistical data is 1 case for 1700 newborns. Quite often hernia of the diaphragm is combined with other developmental defects (congenital hip dislocation, pyloric stenosis, heart defects). Such co-morbidities account for 6-8%.
The hernia of the esophageal opening of the diaphragm in the fetus develops due to the slowing down of the rate of lowering the stomach from the thoracic cavity to the abdominal cavity and the absence of clogging of the air-intestinal pockets, resulting in the formation of hernial sacs.
The congenital hernia of the diaphragm, including its slit-like defects, occurs in the anatomically "weak" parts of the diaphragm - the sternum-rib, the lumbar triangle, etc. The formation of thinned zones or even through defects in the diaphragm occurs at very early stages of embryo and fetal development. Violation of trophic processes in the muscular insertion of the diaphragm leads to a slowed rate of its development, and increased intra-pleural intra-abdominal pressure causes the abdominal cavity to move to the thoracic cavity and occurs in the last weeks of intrauterine life.
In newborns with a slit-like defect in the posterior part of the diaphragm, cyanosis of the skin, vomiting, and displacement of the heart are observed. Critical in the diagnosis of such conditions are X-ray methods of examining the chest. Treatment, as a rule, operative, and with asphyxiated infringement of a hernia in a newborn such operations are carried out urgently, as it is important and at ruptures of a diaphragm.
In the process of such operation, in the newborn, with a small abdominal volume that does not contain organs that are reduced from the pleural cavity, the first stage of the operation creates an artificial ventral hernia, which is then eliminated in the second stage within 6 days to 12 months after the first operation. Also, the pleural cavity is drained. Unfortunately, according to statistics, 50% of operated children experience postoperative complications. There are common complications (such as fever, respiratory center depression, water-salt metabolism disorders), pulmonary complications (pleurisy, pneumonia, edema), complications from the abdominal cavity (various types of intestinal obstruction), as well as excessive increase in intra-abdominal pressure , which is accompanied by restriction of diaphragm movements and compression of the inferior vena cava.
With hernias located next to the esophagus - the so-called para-esophageal hernia, most often there are relapses after operations. To avoid this, after the period of breastfeeding, in addition to the prescribing doctor's prescription, a diet with a diaphragmatic hernia prescribed by a dietician should be followed.
Even with the condition of timely operation in newborns with diaphragmatic hernias, lethality is up to 10 -12%.
Author: doctor Derjushev A.N.
The diet recommended for diaphragmatic hernias is not just some tips on the use of certain products, but rather a set of activities that occupies an important place in the overall treatment plan for this disease. As with many diseases of the gastrointestinal tract, with diaphragmatic hernias, more frequent meals are recommended, but the volume of servings is reduced.
author: doctor Obukhova Yu.A.
The intervertebral hernia of Schmorl is a structural formation of the spine, which is manifested by the insertion of the intervertebral disc into the body of the vertebra.
author: doctor Ainullin AA
Hernia Schmorl is a disease of the spine, in which the intervertebral disc is pressed into the body of the higher or lower vertebra. This is due to the thinning of the osseous plate, which delimits the vertebral body from the intervertebral disc. Most often, the lumbar spine is affected, since it has the main load, but a Schmorl hernia can appear in any part of the spine with predisposing factors.
author: doctor Filonenko AI
Very often the draftee and his parents are interested in the question: "Are they taking Shmorl's hernia into the army?". Let's first figure out what kind of disease it is and what symptoms it accompanies. With the hernia of Schmorl from the intervertebral disc, the cartilage is pressed into the vertebral body. This disease can be one of the syndromes of Sheyerman-Mau disease. In addition, the hernia of Schmorl often appears in kyphosis - a strong stoop.
author: doctor Krivega M.S.
Not everyone easily gets the children, some parents and their kids pay for the happiness of being together too expensive, getting health problems. Unfortunately, not all of them can be prevented. Hematoma, which occurs at birth, refers to such diseases.
Predispose to the appearance of hematoma such factors: