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 common types of CDH:

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

Holes located toward the side of the chest, or Bochdalek hernias, cause more severe problems than Morgagni hernias. Here, we discuss Bochdalek hernias.

Congenital Diaphragmatic Hernia in Children

Congenital diaphragmatic hernia is present at birth (congenital). It occurs early in pregnancy while the diaphragm is forming. Doctors do not know the exact cause. 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 into the chest. The intestines slip through most often. Other organs that can slip through are the stomach, liver, spleen, and, once in a while, the kidneys.

These organs take up space that should be available for a baby's lungs to grow. As a result, babies born with CDH have smaller lungs than normal. Some of these babies also have trouble with high blood pressure in their lungs (pulmonary hypertension). This can keep blood from getting to the lungs easily to pick up oxygen.

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 require treatment.

Congenital Diaphragmatic Hernia at Seattle Children's

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

Our surgeons are experienced at performing the operation to repair CDH in children. We are also experienced in providing specialized care for babies with CHD in our neonatal intensive care unit (NICU). Your child's surgery team works closely with neonatologists. We also work with lung (pulmonary) doctors to provide the best plan of care for your child. For patients with severe breathing problems, we have an Extracorporeal Life Support Program. Our Surgery Pulmonary Follow-Up Clinic helps support your child's ongoing health, growth and development.

When you come to Seattle Children's, you have a team of people to care for your child before, during and after surgery. Along with your child's surgeon, we connect you with neonatologists, pulmonary doctors, nurses, child life specialists and social workers. We work together to meet all of your child's health needs and help your family through this experience.

Since 1907, Seattle Children's has been treating children only. Our team members are trained in their fields and also in meeting the unique needs of children. For example, the doctors who give your child anesthesia are board certified in pediatric anesthesiology. This means they have extra years of training in how to take care of kids. Our child life specialists know how to help children understand their illnesses and treatments in ways that make sense for their age. Our expertise in pediatrics truly makes a difference for our patients and families.