Congenital diaphragmatic hernia
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Congenital diaphragmatic hernia
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USMLE® Step 1 style questions USMLE
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A 2-hour-old male neonate develops difficulty breathing while in the nursery. He was born at 36-weeks gestational age via a vaginal delivery. Prenatal development was complicated by maternal gestational diabetes. The patient’s vitals are notable for tachypnea. Physical exam reveals nasal flaring and intercostal retractions. The apical impulse is displaced to the right. Imaging is ordered, and the results are as follows:
Image reproduced from Radiopedia
Which of the following best describes the cause of this patient’s respiratory presentation?
Image reproduced from Radiopedia
Which of the following best describes the cause of this patient’s respiratory presentation?
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Summary
Congenital diaphragmatic hernia (CDH) is a birth defect in which the diaphragm doesn't form properly, resulting in the protrusion of abdominal organs into the chest cavity. Most babies with CDH have problems breathing and need surgery within the first few days of life. Without treatment, they may be life-threatening complications such as hypoxia, intestinal obstruction, incarceration, and perforation.