A Bochdalek hernia is a congenital defect of the diaphragm; it is also called a diaphragmatic hernia. A hole in the diaphragm develops while the fetus is in the womb, and abdominal organs migrate up into the chest cavity. The hernia and its accompanying symptoms are usually obvious when the baby is born. It is a life-threatening condition and is corrected by surgery.
Bochdalek hernias are usually apparent at birth.
Description
A Bochdalek hernia is caused by a hole in the left side of the diaphragm, according to the University of Virginia Health System. The diaphragm is the muscle that separates the chest cavity from the rest of the abdomen. When the fetus is developing, the diaphragm does not form properly, leaving a hole, and while the fetus is in utero, its internal organs can migrate through the hole.
Symptoms
Symptoms of a Bochdalek hernia appear soon after birth, according to the National Institutes of Health (NIH). The baby will usually have trouble breathing because of the pressure on his lungs from the other organs, or he may be breathing very rapidly. He may also appear blue from the lack of oxygen. Doctors may notice irregular chest movements, a fast heart rate, bowel sounds in the chest area instead of the abdomen, and an abdomen that appears less full than normal for a newborn.
Treatment
Surgery is the only treatment available for a Bochdalek hernia, according to the NIH. A surgeon pushes the displaced organs back to their proper positions and closes the hole in the diaphragm. Depending on the baby's condition, doctors may place the baby on life-support machines to help her breathe until her lungs have a chance to develop further.
Long-Term Complications/Symptoms
Babies who have had a Bochdalek hernia may have long-term health concerns, according to the University of Virginia Health System. The infant may have chronic lung disease because of her initially underdeveloped lungs. The child may have gastroesophageal reflux disease, in which stomach acids come up into the esophagus; this condition is painful and can cause feeding problems. Others may not grow properly---commonly called "failure to thrive"---or have developmental delays or hearing loss. Medical intervention may be necessary for years, depending on the extent of the complications.
Symptoms in Adults
On very rare occasions, an adult may develop a Bochdalek hernia, according to a report published in a 2009 issue of "The Internet Journal of Surgery." An adult with this medical condition experiences some of the same symptoms that babies manifest, including fast breathing, difficulty breathing, a fast heart rate and pain in the abdomen, especially after eating. As with infants, this is a life-threatening emergency and requires immediate medical attention.
