Congenital diaphragmatic hernia physical examination: Difference between revisions

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{{Congenital diaphragmatic hernia}}
{{Congenital diaphragmatic hernia}}
 
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==Overview==
==Overview==
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<ref name="pmid203015333">{{cite journal| author=Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Gripp KW | display-authors=etal| title=GeneReviews® | journal= | year= 1993 | volume=  | issue=  | pages=  | pmid=20301533 | doi= | pmc= | url= }}</ref>


==Physical Examination==
==Physical Examination==
===General Appearance===
Neonate in some respiratory distress depending on the size of the defect. Often accompanied by the presence of a scaphoid abdomen.


===Vitals===
===Vitals===


*[[Tachycardia]] may be present
*[[Pulse]]: > 100/minute
*[[Tachypnea]]
*[[Temperature]]: normal
====Skin====
*Respiratory Rate: increased ([[tachypnea]])
 
===Examination According to Systems===
'''[[ENT]]'''


* Bluish colored skin due to lack of oxygen
*No significant findings


==== Lungs ====
'''[[Skin]]'''
 
*Bluish colored skin due to lack of oxygen
 
'''[[Cardiovascular]]'''
 
*[[Tachycardia]]
 
'''[[Pulmonary]]'''


Examination of the infant shows:
Examination of the infant shows:
* Irregular chest movements
* Absent breath sounds on affected side


==== Abdomen ====
*Irregular chest movements
*Absent breath sounds on affected side


* Bowel sounds heard in the chest
'''[[Neurological]]/ [[Psychological]]'''<ref name="pmid20301533">{{cite journal| author=Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Gripp KW | display-authors=etal| title=GeneReviews® | journal= | year= 1993 | volume=  | issue=  | pages=  | pmid=20301533 | doi= | pmc= | url= }}</ref>
* Abdomen feels less full on examination by touch (palpation)
 
*[[Motor developments]] that improve with time
 
*Nonfocal neurologic abnormalities
*[[Sensorineural hearing loss]]<ref name="pmid323105362">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume=  | issue=  | pages=  | pmid=32310536 | doi= | pmc= | url= }}</ref>
 
'''[[Renal]]'''
 
*[[Kidney stones]]<ref name="pmid81766023">{{cite journal| author=Lund DP, Mitchell J, Kharasch V, Quigley S, Kuehn M, Wilson JM| title=Congenital diaphragmatic hernia: the hidden morbidity. | journal=J Pediatr Surg | year= 1994 | volume= 29 | issue= 2 | pages= 258-62; discussion 262-4 | pmid=8176602 | doi=10.1016/0022-3468(94)90329-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8176602  }}</ref>
 
'''[[GIT]]'''/ '''[[Abdominal]]'''
 
*[[Feeding difficulties]] leading to failure to thrive
*[[Gastroesophageal reflux]]<ref name="pmid32310536">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume=  | issue=  | pages=  | pmid=32310536 | doi= | pmc= | url= }}</ref>
*Bowel sounds heard in the chest
*Abdomen feels less full on examination by touch (palpation)
*[[Bowel obstruction]]<ref name="pmid81766022">{{cite journal| author=Lund DP, Mitchell J, Kharasch V, Quigley S, Kuehn M, Wilson JM| title=Congenital diaphragmatic hernia: the hidden morbidity. | journal=J Pediatr Surg | year= 1994 | volume= 29 | issue= 2 | pages= 258-62; discussion 262-4 | pmid=8176602 | doi=10.1016/0022-3468(94)90329-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8176602  }}</ref>
 
'''[[Muscular]]'''<ref name="pmid203015332">{{cite journal| author=Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Gripp KW | display-authors=etal| title=GeneReviews® | journal= | year= 1993 | volume=  | issue=  | pages=  | pmid=20301533 | doi= | pmc= | url= }}</ref>
 
*[[Chest asymmetry]]
*[[Pectus excavatum]]
*Varying degrees of [[scoliosis]]
 
'''[[Genitourinary]]'''
 
*[[Vesicoureteral reflux]]<ref name="pmid8176602">{{cite journal| author=Lund DP, Mitchell J, Kharasch V, Quigley S, Kuehn M, Wilson JM| title=Congenital diaphragmatic hernia: the hidden morbidity. | journal=J Pediatr Surg | year= 1994 | volume= 29 | issue= 2 | pages= 258-62; discussion 262-4 | pmid=8176602 | doi=10.1016/0022-3468(94)90329-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8176602  }}</ref>
 
'''[[Hematological]]'''
 
*No significant findings


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


[[Category:Needs content]]
[[Category:Gastroenterology]]
 
[[Category:needs english review]]
{{WH}}
{{WS}}

Latest revision as of 01:35, 7 August 2022

Congenital diaphragmatic hernia Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S

Overview

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]

Physical Examination

General Appearance

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

Vitals

Examination According to Systems

ENT

  • No significant findings

Skin

  • Bluish colored skin due to lack of oxygen

Cardiovascular

Pulmonary

Examination of the infant shows:

  • Irregular chest movements
  • Absent breath sounds on affected side

Neurological/ Psychological[2]

Renal

GIT/ Abdominal

Muscular[7]

Genitourinary

Hematological

  • No significant findings

References

  1. Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Gripp KW; et al. (1993). "GeneReviews®".   ( ):  . PMID 20301533.
  2. Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Gripp KW; et al. (1993). "GeneReviews®". PMID 20301533.
  3. "StatPearls".   ( ). 2022:  . PMID 32310536 Check |pmid= value (help).
  4. Lund DP, Mitchell J, Kharasch V, Quigley S, Kuehn M, Wilson JM (1994). "Congenital diaphragmatic hernia: the hidden morbidity". J Pediatr Surg. 29 (2): 258–62, discussion 262-4. doi:10.1016/0022-3468(94)90329-8. PMID 8176602.
  5. "StatPearls".   ( ). 2022:  . PMID 32310536 Check |pmid= value (help).
  6. Lund DP, Mitchell J, Kharasch V, Quigley S, Kuehn M, Wilson JM (1994). "Congenital diaphragmatic hernia: the hidden morbidity". J Pediatr Surg. 29 (2): 258–62, discussion 262-4. doi:10.1016/0022-3468(94)90329-8. PMID 8176602.
  7. Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Gripp KW; et al. (1993). "GeneReviews®". PMID 20301533.
  8. Lund DP, Mitchell J, Kharasch V, Quigley S, Kuehn M, Wilson JM (1994). "Congenital diaphragmatic hernia: the hidden morbidity". J Pediatr Surg. 29 (2): 258–62, discussion 262-4. doi:10.1016/0022-3468(94)90329-8. PMID 8176602.