Congenital diaphragmatic hernia physical examination

Generally, affected neonates present with respiratory distress, but this may be dependent on the size of the defect to some extent. Tachypnea and tachycardia are common findings. The skin often appears cyanotic. Physical exam findings are of a wide variety and present with findings affecting all systems except ENT and hematological. Children born with CDH should be evaluated for structural birth defects such as cardiovascular, CNS, genitourinary, craniofacial, and ocular defects^[1]

Neonate in some respiratory distress depending on the size of the defect. Often accompanied by the presence of a scaphoid abdomen.

• Pulse: > 100/minute
• Temperature: normal
• Respiratory Rate: increased (tachypnea)

ENT

• No significant findings

Skin

• Bluish colored skin due to lack of oxygen

Cardiovascular

• Tachycardia

Pulmonary

Examination of the infant shows:

• Irregular chest movements
• Absent breath sounds on affected side

Neurological/ Psychological^[2]

• Motor developments that improve with time

• Nonfocal neurologic abnormalities
• Sensorineural hearing loss^[3]

Renal

• Kidney stones^[4]

GIT/ Abdominal

• Feeding difficulties leading to failure to thrive
• Gastroesophageal reflux^[5]
• Bowel sounds heard in the chest
• Abdomen feels less full on examination by touch (palpation)
• Bowel obstruction^[6]

Muscular^[7]

• Chest asymmetry
• Pectus excavatum
• Varying degrees of scoliosis

Genitourinary

• Vesicoureteral reflux^[8]

Hematological

• No significant findings