The typical clinical presentation of CDH is of newborn respiratory distress. As this defect occurs during the same period that the abdominal viscera are returning to the abdomen, an opening in the diaphragm allows the viscera to fill the chest cavity as well as the abdomen. The newborn x-rays above and below show the stomach and bowel in the chest.
The initial approach to these patients was for immediate operative intervention to get the abdominal viscera out of the chest. However, though the procedure usually went smoothly, the children often did not survive. Over time, pediatric surgeons and neonatologists have learned that the real problem in CDH is not the abdominal viscera in the chest, but the fact that the viscera has prevented the lung from reaching maturity.
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