The diaphragm is the main muscle used for breathing. When it moves, it expands the chest, creating negative pressure needed for inhaling. If the diaphragm tears and abdominal organs push into the chest, often leading to high risks of illness and death. The two types of diaphragmatic hernia in adults. Read on to learn more about them.
Different Types of Diaphragmatic Hernia
Medical professionals classify diaphragmatic hernias based on their origins. Following are the two main types:
Congenital Diaphragmatic Hernia (CDH)
This type occurs due to a developmental defect in the diaphragm during fetal growth, allowing abdominal organs to move into the chest. There are two main subtypes:
- Bochdalek Hernia: The most common type, making up about 70-75% of cases. It usually occurs on the left side, with a defect in the back and side of the diaphragm, allowing organs like the stomach, liver, or intestines to move into the chest. It’s often detected shortly after birth due to breathing problems.
- Morgagni Hernia: Less common, accounting for about 20-25% of cases. It involves a defect at the front of the diaphragm and often appears later in life. Morgagni hernias may also push abdominal organs into the chest, but they typically cause fewer breathing issues compared to Bochdalek hernias.
Acquired Diaphragmatic Hernia
These hernias develop later in life and have several causes:
- Traumatic Diaphragmatic Hernia: It develops due to an injury to the diaphragm from blunt or sharp trauma, creating a tear that allows abdominal organs to enter the chest.
- Hiatal Hernia: A type where part of the stomach pushes through the diaphragm into the chest. It usually occurs in adults and is often linked to acid reflux (GERD).
- Iatrogenic Diaphragmatic Hernia: This type occurs as an accidental result of surgery that damages the diaphragm.
Symptoms of Diaphragmatic Hernia in Adults
Detecting diaphragmatic hernias can be challenging and often requires a high level of awareness. Many patients show no symptoms, with up to 53% of cases from blunt trauma and 44% from penetrating trauma going unnoticed. Routine chest X-rays catch only 33% of hernias when first reviewed by the trauma team leader. Missed hernias can lead to serious health complications and even death. Therefore, they require specialized hernia repairs. Following are some symptoms:
- Respiratory Distress
Babies born with congenital diaphragmatic hernia (CDH) often have trouble breathing shortly after birth. They may breathe quickly, struggle to get enough oxygen (causing low oxygen levels), and develop a bluish tint on their skin (cyanosis).In adults or older children, symptoms may include shortness of breath and chest pain, especially after an injury.
- Abdominal Symptoms
The abdomen may appear sunken (scaphoid) due to abdominal organs shifting up into the chest. Bowel sounds may be heard in the chest if the intestines have moved up. - Reduced or Absent Breath Sounds
During an exam, healthcare providers may find that breath sounds on the affected side are weak or absent, especially if lung development is affected. - Rapid Heart Rate
The heart may beat faster as the body tries to cope with low oxygen levels. - Gastrointestinal Symptoms
In some cases, especially with acquired diaphragmatic hernias, symptoms can include recurring abdominal pain, feeling full after eating, vomiting, and symptoms of digestive blockages. - Delayed Symptoms
While many cases show symptoms at birth, some congenital diaphragmatic hernias don’t cause issues until later in childhood, sometimes triggered by infections or other abdominal problems.
Closing Note
The two types of diaphragmatic hernia in adults can be fatal if you ignore the symptoms. Therefore, you are advised to get a proper diagnosis upon noticing any of the signs mentioned earlier.
Visit Dr. Rick N. Ngo at Texas Hernia & Surgical Specialists. Our doctor has performed more than 1,500 minimally invasive hernia surgeries during his career. Call us at (888) 365-1544 for an appointment.