Spontaneous Acquired Diaphragmatic Hernia: Case Series and Review of Literature.

Abstract

Congenital diaphragmatic hernia (CDH) and acquired diaphragmatic hernia (ADH) are secondary to a weakness or opening in the diaphragm. Both are types of internal hernia. The abnormality can range from a minor defect in the posterior edge of the diaphragm to the entire loss of it. CDH usually leads to lung hypoplasia associated with pulmonary hypertension and immaturity, as well as cardiac dysfunction. In ADH, pathophysiology is secondary to herniation and its pressure effects. We report a series of two cases of spontaneous ADH (SADH). Spontaneous acquired rupture of the diaphragm can occur after exercise, coughing, labor (delivery), or even without any significant preceding event. It is uncertain if SADH is caused by a preexisting weak region in the diaphragm, a loss of muscle coordination during vigorous exertion, or both. It is a potentially fatal surgical emergency requiring a high index of clinical judgment in the appropriate clinical setting. SADH acts mechanically by compressing the lung. It is an infrequent entity. This case series and review concisely illustrate the genesis, diagnosis, and treatment of spontaneous diaphragmatic hernia.