Digestive and Gastrointestinal Conditions

Congenital Diaphragmatic Hernia (CDH)

What is congenital diaphragmatic hernia?

A congenital diaphragmatic hernia (CDH) occurs when the thin muscle that separates the chest from the belly, called the diaphragm, does not form completely. This leaves a hole between the belly (abdomen) and chest.

There are two main types of CDH:

  • Hole toward the side of the chest (Bochdalek)
  • Hole in front (Morgagni)

Bochdalek hernias (hole toward the side) are 10 times more common than Morgagni hernias (hole in front), and they cause more severe problems. These CDH pages are about Bochdalek hernias. Learn more (PDF).

Congenital Diaphragmatic Hernia in Children

A CDH is present at birth (congenital). The problem occurs early in pregnancy while the diaphragm is forming. Doctors do not know what causes CDH. It occurs in about 1 in every 4,000 babies.

In babies with CDH, organs that should be in the belly can slip through the hole in the diaphragm up into the chest. Most often, the intestines slip through. However, the stomach, liver and spleen can also slip through.

When organs from the belly are up in the chest, they push on the baby’s lungs, which slows lung growth. As a result, babies born with CDH have smaller lungs than normal. They may have trouble breathing and other symptoms.

Some babies with CDH also have high blood pressure in their lungs (pulmonary hypertension). High blood pressure in the lungs can keep blood from getting through the lungs, which means less oxygen gets to the body.

Some babies with CDH have other health problems at birth, such as small hearts or a hole in their hearts (ventricular septal defect). These problems may also need treatment.

Congenital Diaphragmatic Hernia at Seattle Children’s

We have treated many babies with CDH at Seattle Children’s. In a typical year, we see about 15 to 20 babies with this condition.

If doctors see CDH on an ultrasound before your baby is born, our Prenatal Diagnosis and Treatment team can monitor your baby’s condition and plan for the care your baby may need after birth.

Our surgeons are experienced at performing the surgery to repair CDH in children. Even more important, we work with a team of specialists to provide total expert care for babies with CDH. Your baby’s team at Seattle Children’s will include pediatric surgeons, neonatologists (newborn specialists), cardiologists (heart specialists) and pulmonologists (lung specialists).

For babies with severe breathing problems, we have an Extracorporeal Life Support Program to provide heart-lung bypass support.

Team care starts right away in our Level IV Neonatal Intensive Care Unit (NICU), and it continues through every step in your baby’s care — as your baby has surgery, moves to a regular hospital room to recover and comes back to Seattle Children’s for clinic visits.

When your baby is able to go home, our Surgery Pulmonary Follow-Up (SPF) Clinic provides long-term care to support your child’s ongoing health, growth and development.

Read more about expert treatment for CDH at Seattle Children’s.

Contact Us

If you have questions about congenital diaphragmatic hernia treatment, call our General and Thoracic Surgery Department at 206-987-2794.