Congenital diaphragmatic hernia physical examination
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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. Children born with CDH should be evaluated for structural birth defects such as cardiovascular, CNS, genitourinary, craniofacial, and ocular defects.[1]
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
- Pulse: > 100/minute
- Temperature: normal
- Respiratory Rate: increased (tachypnea)
Examination According to Systems
- No significant findings
- Bluish colored skin due to lack of oxygen
Examination of the infant shows:
- Irregular chest movements
- Absent breath sounds on affected side
Neurological/ Psychological [2]
- Motor developments that improve with time
- Nonfocal neurologic abnormalities
- Sensorineural hearing loss [3]
- Feeding difficulties leading to failure to thrive
- Gastroesophageal reflux [5]
- Bowel sounds heard in the chest
- Abdomen feels less full on examination by touch (palpation)
- Bowel obstruction [6]
- Chest asymmetry
- Pectus excavatum
- Varying degrees of scoliosis
- No significant findings
References
- ↑ Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Gripp KW; et al. (1993). "GeneReviews®". ( ): . PMID 20301533.
- ↑ Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Gripp KW; et al. (1993). "GeneReviews®". PMID 20301533.
- ↑ "StatPearls". ( ). 2022: . PMID 32310536 Check
|pmid=value (help). - ↑ 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.
- ↑ "StatPearls". ( ). 2022: . PMID 32310536 Check
|pmid=value (help). - ↑ 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.
- ↑ Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Gripp KW; et al. (1993). "GeneReviews®". PMID 20301533.
- ↑ 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.