Lung ultrasound findings in congenital diaphragmatic hernia
Congenital diaphragmatic hernia (CDH) occurs in approximately 1 in 2500 to 5000 infants. The use of lung ultrasound (LUS) for its diagnosis has been reported in only two case reports. The aim of this study was to report the LUS pattern of CDH in a case series of infants with respiratory distress. This case series was part of a cohort enrolled in a larger prospective observational study. LUS was performed at the point-of-care during the first 24 h of life of the neonates and its operation time was measured. Seven cases (six left and one right CDH) were diagnosed. We found that the pattern of LUS for CDH diagnosis includes (1) partial absence of the hyperechoic line representing the normal diaphragmatic profile, (2) partial absence of the pleural line in the affected hemithorax, (3) absence of A lines in the affected area, (4) presence of multi-layered area with hyperechoic contents in motion (normal gut), and (5) possible presence of parenchymatous organs inside the thorax (i.e., liver or spleen).
What is Known:
• Congenital diaphragmatic hernia occurs in approximately 1 in 2500 to 5000 infants but the use of lung ultrasound for its diagnosis has been reported in only two case reports.
What is New:
• Research provided a description of lung ultrasound pattern in infants with congenital diaphragmatic hernia.
• Lung ultrasound at the point-of-care may allow a prompt diagnosis of congenital diaphragmatic hernia, particularly useful in cases of missed prenatal diagnosis.
KeywordsCongenital diaphragmatic hernia Lung ultrasound Neonate Intensive care
Congenital diaphragmatic hernia
Dr. Iuri Corsini and Dr. Niccolò Parri has equally contributed to the paper, serve as guarantors of the paper, and were responsible for study conception, design, execution, data analysis, and writing the manuscript.
Dr. Caterina Coviello and Dr. Valentina Leonardi enrolled patients, designed the data collection instruments, collected data reviewed, and revised the manuscript.
Prof. Carlo Dani supervised the project, provided oversight of the study, refined the study design and the design of the study protocol and data form, and critically reviewed the manuscript for important intellectual content.
All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The study was approved by the local Ethical Committee. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Ultrasonographic findings of CDH. Note the absence of the hyperechoic line that represents the pleura and the absence of the normal A lines. The presence of a multi-layered area with hyperechoic contents typical of the normal intestine instead of the normal pulmonary parenchyma can be seen. (MOV 13597 kb)
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