The congenital diaphragmatic hernia is a relatively rare but a challenging problem, which frequently demand prompt and decisive action on the part of the attending physician in order to save the patient, and is an important cause of respiratory distress in the neonates. Even though the survival of infants with diaphragmatic hernias steadily improved until recently, the high mortality rate is associated with specific derangements of respiratory function.
The present study deals with clinical analysis of 21 cases of Bochdalek hernia among 37 cases congenital diaphagmatic hernia operated upon at Yonsei Medical Center during 10 years from 1974 to 1983.
There were 21 cases of Bochdalek hernia, 14 cases of diaphragmatic eventration and 2 cases of Morgagni hernia. The relative male to female incidence was 2.5: 1 for Bochdlek hernia (15: 6). The left: right side incidence of Bochdalek hernia was 18: 3.
The arterial blood gas study was helpful on assessing the prognosis of patient, blood sam-ples from radial and temporal arteries would be representative of blood perfuses the heart, brain and eyes.
We employed the transabdominal approach in 11 cases, the transthoracic approach in 4 cases and both approach in 3 cases. All were repaired primarily with nonabsorbable inter-rupted sutures.
Associated pulmonary hypoplasia and the age of patient appeared to be major determinants in mortality rate. In this study 29% of all patients died. Of the 18 patients operated on, there were 4 deaths, an overall mortality rate of 22%. The mortality of the patient without pul-monary hypoplasia was 8%.
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