Congenital Anomalies of the Diaphragm in Children

Twenty children with various diaphragmatic anomalies, managed over a period of 3 years, are presented. These included congenital diaphragmatic hemia (CDH 10), congenital eventration of diaphragm (CDE 6) and hiatus hernia with gastro-esophageal reflux (HH-GER 4). Clinical presentation of these children was: respiratory distress (7), recurrent respiratory tract infcction \\1' failure to thrive (II) and gastric volvulus (3). Two patients ofgastric volvulus had acute surgical abdomen The patients in respiratory distress group were all newborns with CDH. Whereas, those \\ho had gastnc volvulus were CDE 2 and HH-GER I. All children were operated through left s' IStal transabdominal approach, except those with HH-GER who were explored through upper mldlinc ll1CISlon. Repair of diaphragmatic defect/plication was done in patients with CDHlCDE, \\li,r~as issen fundoplication (Loose wrap) was done in patients of HH-GER. Threc newborns \11th CDH and one child with CDE and gastric volvulus died. All other 16 surviving children are domg well after 4 months to 3 years of follow up.