Child health · UKMLA & AKT
Diaphragmatic hernia
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Respiratory distress - tachypnoea, grunting, nasal flaring, subcostal recession, cyanosis from birth
- Absent breath sounds on the affected side (usually left) - bowel occupies thorax
- Bowel sounds in the chest - tinkling/gurgling on auscultation (highly specific)
- Displaced heart sounds - mediastinal shift pushes heart to the right; heart sounds loudest on right
- Scaphoid abdomen - abdominal contents have migrated into chest
- Cyanosis - from pulmonary hypoplasia and right-to-left shunting via persistent pulmonary hypertension (PPH)
Scaphoid abdomen + cyanosis + heart sounds displaced to the right = CDH until proven otherwise. Most neonatal respiratory distress causes a normal or distended abdomen - a sunken abdomen is the key discriminator.
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