2018 Vol.4 No.1:2 Commentary DOI: 10.21767/2471-805X.100035 iMedPub Journals www.imedpub.com 1 © Under License of Creative Commons Attribution 3.0 License | This article is available in: http://pediatrics.imedpub.com/archive.php Journal of Pediatric Care ISSN 2471-805X Abstract Congenital diaphragmatc hernia is a conditon characterized by a defect in the diaphragm that leads to the protrusion of the abdominal contents in the thoracic cavity which interferes in the pulmonary development. Diaphragmatc eventraton is a very infrequent conditon in children, asymptomatc or commonly present with low or gastrointestnal respiratory manifestatons and whose diagnosis is based on an incidental fnding when requestng images to verify a diagnostc suspicion occurring in most cases of late occurrence. It can be of congenital or acquired cause. The prognosis in general is good, with probable complicatons being chronic lung infecton, diaphragmatc rupture, ulcers and stomach volvulus. Treatment is a topic depend size and locaton of the defect, size and locaton of the defect, some pediatric surgeons do not operate if the patent is asymptomatc and only plicate the symptomatc patents. Due to its importance in pediatric populaton, through this is intended to make a quick review of the updated literature on the subject contributng to have relevant informaton regarding the issue cooperatng with the diagnosis and appropriate treatment in our practce. Keywords: Congenital Diaphragmatc Hernia (CDH); Diaphragmatc eventraton; Diaphragmatc hernia; Congenital anomalies Pediatric Congenital Diaphragmatc Hernia Received: November 22, 2017; Accepted: April 10, 2018; Published: April 13, 2018 Irina Suley Tirado Pérez 1* , Ulfran De Jesús Castro Salas 2 and Andrea Carolina Zarate Vergara ACZ 3 1 Master Pediatric Palliatve Care, Pediatric Intensive Care Student, University of Santander, Colombia 2 Pediatric Teacher, University of Santander, Colombia 3 Pediatric Intensive Care Student, University of Santander, Colombia Corresponding author: Irina Suley Tirado Pérez  irinasuley@gmail.com Magister Pediatric Palliatve Care, Center for Research and Teaching, Graduate Student of Pediatric Intensive Care Level I, University of Santander, Columbia. Tel: 3145598697 Citation: Pérez IST, Salas UDJC, Vergara ACZ (2018) Pediatric Congenital Diaphragmatc Hernia. J Pedfafr Care. Vof.4 No.1:2 Introducton Congenital diaphragmatc hernia (CDH) is a defect that occurs in 1 in 3,000 live births, of which approximately 60% occur in isolaton without other congenital anomalies. This is a rare congenital anomaly of the diaphragm that occurs due to poor embryogenesis with atrophy of the diaphragm muscle fbers and loss of muscle tone. It is more frequent on the lef side, and bilateral cases have been reported, male predominance is also recognized. It is associated with gestaton infectons such as rubella and cytomegalovirus, Jarcho-Levin's spóndyl- thoracic dysplasia, malformatons such as pulmonary hypoplasia, pulmonary sequestraton, congenital heart disease, renal ectopia, gastric volvulus, chromosomal diseases, various myopathies and spinal cord abnormalites. Ofen the diagnosis of diaphragmatc eventraton is a fnding when performing chest X-rays in a respiratory distress syndrome or in febrile conditons. Considering that many patents are asymptomatc but at the same tme with bronchial segmentaton and alveolar multplicaton extending up to 8 years of age and that the partal occupaton of the hemithorax is directly detrimental to the complete development of that lung, raises the discussion about the indicaton and tming of the surgical correcton of this pathology. The most frequent defect occurs in the lef posterolateral region of the diaphragm (Bodahlek hernia), but may be right in 15% of cases or bilateral in about 1-2%. Complete agenesis of the diaphragm and eventraton are very rare manifestatons. The prenatal diagnosis of CDH is has been increased thanks to prenatal ultrasound screening programs, from being a diagnosis of neonatal urgency to an increasingly well-known conditon since the fetal stage. Immediate treatment at birth includes bowel decompression, avoidance of mechanical ventlaton to the extent possible. The main management focus includes non-invasive ventlaton, hemodynamic monitoring and treatment of pulmonary hypertension followed by surgery. Although inhaled nitric oxide is not approved by the FDA for the treatment of CDH-induced pulmonary hypertension, it is commonly used. Extracorporeal membrane oxygenaton (ECMO) is typically considered afer the failure of conventonal medical treatment for neonates with gestatonal age ≥ 34 weeks or weighing >2 kg with CDH that do not have large associated lethal abnormalites. Multple factors