The human body contains structures that hold the internal organs in place, including the abdominal wall at the front of the body and the muscular diaphragm that separates the chest and abdominal cavities. During development in the womb, these structures may not form completely, leaving abnormal openings, or hernias. Congenital hernias vary in severity, depending on their size and location. Symptoms of a hernia at birth depend on the type of hernia present and the organs affected.
Abdominal Wall Opening
Omphalocele and gastroschisis are two types of abdominal wall hernias caused by incomplete closure of the structure during fetal development. Babies with these birth defects have a pronounced opening in the abdominal wall near the site of the umbilical cord. The abdominal organs protrude through the opening, which varies in size from one baby to another. With small hernias, a segment of the intestine usually bulges forth. Large hernias may permit protrusion of most of the stomach, intestines and liver.
The Children's Hospital of Philadelphia explains that with an omphalocele, a clear membrane covers the protruding abdominal organs. In contrast, the intestines and other abdominal organs of babies born with gastroschisis are directly exposed to the external environment. Medical personnel cover the exposed organs immediately after birth to prevent infection and tissue drying.
Feeding Difficulty
Babies born with an omphalocele or gastroschisis typically have feeding difficulties, which may include poorly coordinated sucking and swallowing, reflux of ingested stomach contents into the food pipe and an inability to absorb nutrients, explains the University of Michigan Fetal Diagnosis and Treatment Center. A substantial number of babies with omphalocele or gastroschisis also require mechanical ventilation for a time after birth, which prevents normal feeding.
Breathing Difficulty
A congenital diaphragmatic hernia is the incomplete closure of the diaphragm, which most commonly occurs on the left side of the body. The opening in the diaphragm allows the stomach and intestines to move into the chest cavity, leaving the lungs little room to grow. The lungs remain underdeveloped, a condition called pulmonary hypoplasia. At birth, a baby with a congenital diaphragmatic hernia typically exhibits profound breathing difficulty, reports theCincinnati Children's Hospital Medical Center. Poor lung function leads to insufficient oxygen in the blood, causing the baby to turn blue. Babies with a congenital diaphragmatic hernia typically require immediate respiratory support with mechanical ventilation or a heart/lung bypass machine.
Misshapen Chest or Abdomen
Babies with a congenital diaphragmatic hernia often have a misshapen chest or abdomen caused by the dislocation of the abdominal organs into the chest. One side of the chest may appear abnormally large, due to expansion caused by the abdominal organs. The abdomen may lack the normal, slightly domed shape and appear sunken, note experts at the Lucile Packard Children's Hospital at Stanford.
References
- The Children's Hospital of Philadelphia: Omphalocele
- The Children's Hospital of Philadelphia: Gastroschisis
- University of Michigan Fetal Diagnosis and Treatment Center: Omphalocele
- University of Michigan Fetal Diagnosis and Treatment Center: Gastroschisis
- Cincinnati Children's Hospital Medical Center: Congenital Diaphragmatic Hernia
