{"id":1624,"date":"2026-04-07T05:58:57","date_gmt":"2026-04-07T05:58:57","guid":{"rendered":"https:\/\/drmohamedelbarbary.com\/diaphragmatic-hernia-children-egypt\/"},"modified":"2026-04-07T06:28:01","modified_gmt":"2026-04-07T06:28:01","slug":"diaphragmatic-hernia-children-egypt","status":"publish","type":"page","link":"https:\/\/drmohamedelbarbary.com\/en\/diaphragmatic-hernia-children-egypt\/","title":{"rendered":"Congenital Diaphragmatic Hernia (CDH) in Children"},"content":{"rendered":"

Congenital Diaphragmatic Hernia (CDH) in Children<\/strong><\/h1>\n

Neonatal & Paediatric Surgery | Professor Mohamed Elbarbary, FRCSEd \u2014 Cairo University<\/em><\/p>\n

A diagnosis of congenital diaphragmatic hernia (CDH) is one of the most serious conditions a family can face during pregnancy or in the newborn period. Professor Mohamed Elbarbary \u2014 Cairo University Professor of Paediatric Surgery, Fellow of the Royal College of Surgeons of Edinburgh (FRCSEd 2026), and specialist with over 36 years of experience \u2014 has extensive expertise in the surgical management of CDH and other diaphragmatic defects. This page explains the condition, the treatment approach, and what families can expect.<\/p>\n\n\n
\n

\u2605 About our CDH care:<\/strong><\/p>\n

\u2022 Multi-disciplinary team approach: neonatology, paediatric surgery, PICU<\/p>\n

\u2022 Both open and thoracoscopic (minimally invasive) repair techniques<\/p>\n

\u2022 Management of post-CDH pulmonary hypertension in partnership with neonatologists<\/p>\n

\u2022 Prof. Elbarbary: Cairo University Professor | FRCSEd 2026 | 36+ years experience<\/p>\n<\/td>\n<\/tr>\n<\/table>\n

What Is Congenital Diaphragmatic Hernia?<\/strong><\/h2>\n

The diaphragm is the dome-shaped muscle that separates the chest cavity from the abdomen. In CDH, there is a defect (hole) in the diaphragm that allows abdominal organs \u2014 most commonly the bowel, stomach, and sometimes the liver or spleen \u2014 to herniate (push through) into the chest cavity during fetal development. This interferes with normal lung development and can cause significant respiratory problems at birth.<\/p>\n

CDH occurs in approximately 1 in 2,000\u20134,000 births. The most common type is a left-sided posterolateral defect (Bochdalek hernia), accounting for about 80% of cases. Right-sided CDH and bilateral CDH are less common but often more severe. Morgagni hernias \u2014 anterior diaphragmatic defects \u2014 are a separate, usually less severe condition also treated by paediatric surgeons.<\/p>\n

Diagnosis<\/strong><\/h2>\n

CDH is increasingly diagnosed prenatally by routine fetal ultrasound at the 18\u201320 week anomaly scan, when abdominal organs may be visible in the chest. After birth, CDH typically presents with:<\/p>\n

\u2022 Respiratory distress immediately or shortly after birth \u2014 often severe<\/p>\n

\u2022 Low oxygen saturation despite ventilation<\/p>\n

\u2022 A barrel-shaped chest and a scaphoid (flat) abdomen<\/p>\n

\u2022 Absent or reduced breath sounds on the affected side<\/p>\n

\u2022 Bowel sounds occasionally heard in the chest<\/p>\n

Chest X-ray confirms the diagnosis in almost all cases.<\/p>\n

Treatment<\/strong><\/h2>\n

Stabilisation first<\/strong><\/h3>\n

CDH is not primarily a surgical emergency in the immediate newborn period. The most critical phase is the initial medical stabilisation of the baby in the neonatal intensive care unit (NICU). The key priority is managing pulmonary hypertension (high blood pressure in the lungs \u2014 caused by the compressed, underdeveloped lungs) and establishing stable oxygenation, often with mechanical ventilation. In selected severe cases, ECMO (extracorporeal membrane oxygenation) may be used.<\/p>\n

Surgery is typically planned once the baby has been medically stabilised \u2014 usually within the first few days to 1\u20132 weeks of life, depending on the baby’s condition.<\/p>\n

Surgical repair<\/strong><\/h3>\n

The goal of surgery is to return the herniated abdominal organs to their correct position in the abdomen and to close the diaphragmatic defect. Prof. Elbarbary offers:<\/p>\n

\u2022 Open repair via a subcostal abdominal incision \u2014 the standard approach for large defects, or when stability does not allow laparoscopy<\/p>\n

\u2022 Thoracoscopic (minimally invasive) repair \u2014 for selected stable patients, using small keyhole incisions in the chest wall<\/p>\n

The diaphragmatic defect is repaired with sutures if it is small, or with a synthetic patch (GORE-TEX or similar) if the defect is too large to close primarily. The use of a patch is associated with a higher risk of hernia recurrence over time, which is closely monitored.<\/p>\n

After Surgery<\/strong><\/h2>\n

Recovery from CDH repair is closely monitored in the PICU or NICU. The baby continues on ventilatory support as needed and is weaned carefully as the lungs begin to expand. Pulmonary hypertension management continues post-operatively. Length of hospital stay varies widely by severity \u2014 from 2\u20133 weeks in mild cases to several months in severe cases.<\/p>\n

Long-term follow-up is an essential part of CDH care. Potential long-term issues include:<\/p>\n

\u2022 Recurrent hernia (particularly with patch repairs)<\/p>\n

\u2022 Chronic lung disease and reactive airways in more severe cases<\/p>\n

\u2022 Gastro-oesophageal reflux (common after CDH repair)<\/p>\n

\u2022 Neurodevelopmental follow-up for babies who required ECMO or prolonged ventilation<\/p>\n

Morgagni Hernia<\/strong><\/h2>\n

Morgagni hernias are anterior diaphragmatic defects, often diagnosed incidentally in older children (or even adults). They are typically much less severe than Bochdalek CDH and are often repaired laparoscopically as an elective procedure once diagnosed. Outcomes are excellent.<\/p>\n

Frequently Asked Questions<\/strong><\/h2>\n

Is CDH always diagnosed before birth?<\/strong><\/h3>\n

Not always. While prenatal ultrasound picks up the majority of CDH cases in settings with good antenatal care, some cases \u2014 particularly right-sided or Morgagni hernias \u2014 may first be identified at birth or even later in childhood. Late presentations are generally less severe than those diagnosed prenatally.<\/p>\n

What is the survival rate for CDH?<\/strong><\/h3>\n

Survival rates depend heavily on the severity of the defect, the degree of pulmonary hypoplasia (underdevelopment of the lungs), and the presence of other anomalies. In isolated CDH (without other major defects) managed at experienced centres, survival rates of 70\u201390% are reported. The most severe cases \u2014 particularly those with liver herniation into the chest, very low lung-to-head ratio on prenatal ultrasound, and requirement for ECMO \u2014 carry a higher risk. Every family deserves an honest, individualised discussion of prognosis based on their specific case.<\/p>\n

Will my child need long-term follow-up?<\/strong><\/h3>\n

Yes. CDH survivors require regular multidisciplinary follow-up including respiratory, surgical, nutritional, and developmental assessment. Recurrent hernia, chronic lung disease, feeding difficulties, and growth issues are monitored and managed as needed. Most children with mild to moderate CDH lead normal, active lives.<\/p>\n\n\n
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Book a Consultation with Prof. Elbarbary<\/strong><\/p>\n

Cairo University Specialist | FRCSEd 2026 | 36 Years Experience<\/p>\n

drmohamedelbarbary.com<\/a><\/p>\n<\/td>\n<\/tr>\n<\/table>\n

drmohamedelbarbary.com | Cairo University \u2014 Kasr Al-Ainy | FRCSEd 2026<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Congenital Diaphragmatic Hernia (CDH) in Children Neonatal & Paediatric Surgery | Professor Mohamed Elbarbary, FRCSEd \u2014 Cairo University A diagnosis of congenital diaphragmatic hernia (CDH) is one of the most serious conditions a family can face during pregnancy or in the newborn period. Professor Mohamed Elbarbary \u2014 Cairo University Professor of Paediatric Surgery, Fellow of […]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"difl_page_category":[],"class_list":["post-1624","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/drmohamedelbarbary.com\/en\/wp-json\/wp\/v2\/pages\/1624","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drmohamedelbarbary.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/drmohamedelbarbary.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/drmohamedelbarbary.com\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/drmohamedelbarbary.com\/en\/wp-json\/wp\/v2\/comments?post=1624"}],"version-history":[{"count":1,"href":"https:\/\/drmohamedelbarbary.com\/en\/wp-json\/wp\/v2\/pages\/1624\/revisions"}],"predecessor-version":[{"id":1635,"href":"https:\/\/drmohamedelbarbary.com\/en\/wp-json\/wp\/v2\/pages\/1624\/revisions\/1635"}],"wp:attachment":[{"href":"https:\/\/drmohamedelbarbary.com\/en\/wp-json\/wp\/v2\/media?parent=1624"}],"wp:term":[{"taxonomy":"difl_page_category","embeddable":true,"href":"https:\/\/drmohamedelbarbary.com\/en\/wp-json\/wp\/v2\/difl_page_category?post=1624"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}