Congenital diaphragmatic hernia physical examination: Difference between revisions

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==Overview==
==Overview==
Generally, affected neonates present with [[respiratory distress]], but this may be dependent on the size of the defect to some extent. [[Tachypnea]] and [[tachycardia]] are common findings. The skin often appears [[cyanotic]]. Physical exam findings are of a wide variety and present with findings affecting all systems except [[ENT]] and [[hematological]].


==Physical Examination==
==Physical Examination==
=== General Appearance ===
Neonate in some respiratory distress depending on the size of the defect. Often accompanied by the presence of a scaphoid abdomen.


===Vitals===
===Vitals===


*[[Tachycardia]] may be present
*[[Pulse]]: > 100/minute
*[[Tachypnea]]
* [[Temperature]]: normal
* Respiratory Rate: increased ([[tachypnea]])


====Skin====
<br />


*Bluish colored skin due to lack of oxygen
=== Examination According to Systems ===
'''[[ENT]]'''


====Lungs====
* No significant findings
 
'''[[Skin]]'''
 
* Bluish colored skin due to lack of oxygen
 
'''[[Cardiovascular]]'''
 
* [[Tachycardia]]
 
'''[[Pulmonary]]'''


Examination of the infant shows:
Examination of the infant shows:
Line 23: Line 39:
*Absent breath sounds on affected side
*Absent breath sounds on affected side


====Abdomen====
'''[[Neurological]]/ [[Psychological]]''' <ref name="pmid20301533">{{cite journal| author=Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Gripp KW | display-authors=etal| title=GeneReviews® | journal= | year= 1993 | volume= | issue= | pages=  | pmid=20301533 | doi= | pmc= | url= }}</ref>
 
* [[Motor developments]] that improve with time
 
* Nonfocal neurologic abnormalities
* [[Sensorineural hearing loss]] <ref name="pmid323105362">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume=  | issue=  | pages=  | pmid=32310536 | doi= | pmc= | url= }}</ref>


*Bowel sounds heard in the chest
'''[[Renal]]'''
 
* [[Kidney stones]] <ref name="pmid81766023">{{cite journal| author=Lund DP, Mitchell J, Kharasch V, Quigley S, Kuehn M, Wilson JM| title=Congenital diaphragmatic hernia: the hidden morbidity. | journal=J Pediatr Surg | year= 1994 | volume= 29 | issue= 2 | pages= 258-62; discussion 262-4 | pmid=8176602 | doi=10.1016/0022-3468(94)90329-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8176602  }}</ref>
 
'''[[GIT]]'''/ '''[[Abdominal]]'''
 
* [[Feeding difficulties]] leading to failure to thrive
* [[Gastroesophageal reflux]] <ref name="pmid32310536">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume=  | issue=  | pages=  | pmid=32310536 | doi= | pmc= | url= }}</ref>
* Bowel sounds heard in the chest
*Abdomen feels less full on examination by touch (palpation)
*Abdomen feels less full on examination by touch (palpation)
*[[Bowel obstruction]] <ref name="pmid81766022">{{cite journal| author=Lund DP, Mitchell J, Kharasch V, Quigley S, Kuehn M, Wilson JM| title=Congenital diaphragmatic hernia: the hidden morbidity. | journal=J Pediatr Surg | year= 1994 | volume= 29 | issue= 2 | pages= 258-62; discussion 262-4 | pmid=8176602 | doi=10.1016/0022-3468(94)90329-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8176602  }}</ref>
'''[[Muscular]]''' <ref name="pmid203015332">{{cite journal| author=Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Gripp KW | display-authors=etal| title=GeneReviews® | journal= | year= 1993 | volume=  | issue=  | pages=  | pmid=20301533 | doi= | pmc= | url= }}</ref>
* [[Chest asymmetry]]
* [[Pectus excavatum]]
* Varying degrees of [[scoliosis]]
'''[[Genitourinary]]'''
* [[Vesicoureteral reflux]] <ref name="pmid8176602">{{cite journal| author=Lund DP, Mitchell J, Kharasch V, Quigley S, Kuehn M, Wilson JM| title=Congenital diaphragmatic hernia: the hidden morbidity. | journal=J Pediatr Surg | year= 1994 | volume= 29 | issue= 2 | pages= 258-62; discussion 262-4 | pmid=8176602 | doi=10.1016/0022-3468(94)90329-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8176602  }}</ref>
'''[[Hematological]]'''
* No significant findings


==References==
== References ==
{{Reflist|2}}
{{Reflist|2}}


Revision as of 06:21, 23 April 2022

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S

Overview

Generally, affected neonates present with respiratory distress, but this may be dependent on the size of the defect to some extent. Tachypnea and tachycardia are common findings. The skin often appears cyanotic. Physical exam findings are of a wide variety and present with findings affecting all systems except ENT and hematological.

Physical Examination

General Appearance

Neonate in some respiratory distress depending on the size of the defect. Often accompanied by the presence of a scaphoid abdomen.

Vitals


Examination According to Systems

ENT

  • No significant findings

Skin

  • Bluish colored skin due to lack of oxygen

Cardiovascular

Pulmonary

Examination of the infant shows:

  • Irregular chest movements
  • Absent breath sounds on affected side

Neurological/ Psychological [1]

Renal

GIT/ Abdominal

Muscular [6]

Genitourinary

Hematological

  • No significant findings

References

  1. ↑ Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Gripp KW; et al. (1993). "GeneReviews®". PMID 20301533.
  2. ↑ "StatPearls".   ( ). 2022:  . PMID 32310536 Check |pmid= value (help).
  3. ↑ Lund DP, Mitchell J, Kharasch V, Quigley S, Kuehn M, Wilson JM (1994). "Congenital diaphragmatic hernia: the hidden morbidity". J Pediatr Surg. 29 (2): 258–62, discussion 262-4. doi:10.1016/0022-3468(94)90329-8. PMID 8176602.
  4. ↑ "StatPearls".   ( ). 2022:  . PMID 32310536 Check |pmid= value (help).
  5. ↑ Lund DP, Mitchell J, Kharasch V, Quigley S, Kuehn M, Wilson JM (1994). "Congenital diaphragmatic hernia: the hidden morbidity". J Pediatr Surg. 29 (2): 258–62, discussion 262-4. doi:10.1016/0022-3468(94)90329-8. PMID 8176602.
  6. ↑ Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Gripp KW; et al. (1993). "GeneReviews®". PMID 20301533.
  7. ↑ Lund DP, Mitchell J, Kharasch V, Quigley S, Kuehn M, Wilson JM (1994). "Congenital diaphragmatic hernia: the hidden morbidity". J Pediatr Surg. 29 (2): 258–62, discussion 262-4. doi:10.1016/0022-3468(94)90329-8. PMID 8176602.

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