DURING the past seven years we have observed 33 cases of congenital diaphragmatic hernias at the Children's Memorial Hospital, 31 of which have undergone surgical repair. During the course of this experience, several important points in the care of these patients have been forcefully impressed upon us.
Congenital diaphragmatic hernias may be classified as follows:
The cases being reported are outlined in the Table, and the occurrence of the hernias in various areas of the diaphragm is illustrated in Figure 1.
CONGENITALLY SHORT ESOPHAGUS
In early fetal life, if the stomach descends incompletely behind the septum transversum and does not reach the abdominal cavity before the lumbar portion of the diaphragm is completed, the esophagus may remain short and a portion of the stomach will stay within the thoracic cavity. Because the shortened esophagus enters the uppermost portion of the stomach, the normal relationship of cardia and fundus is lost.