الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The outcome of congenital diaphragmatic hernia is one of the most challenging conditions to be predicted as it has large number of contributing factors and associated anomalies that affect the prognosis.
This is a study of 23 neonates presented with congenital diaphragmatic hernia (CDH) admitted and treated in Pediatric Surgery Unit at El Shatby Children Hospital between January 2016 and December 2016.
As regard the sex and age of presentation, out of the 23 patients, 10 were males (43.5%) and 13 were females (56.5%) and the male: female ratio was 1:1.3 and most of the cases (about 91.7%) were presented during the first week of life, while only 2 cases (8.7%) were presented after 7 days of age.
According to the mode of delivery, sixty five percent (15 cases) of the cases were delivered by caesarian section (CS), while (34.8%) were delivered by normal vaginal delivery.
As regard The gestational age of the cases 15 were full term (65.2%) and only 8 cases were preterm (34.8%).
Patients were divided into 3 groups according to birth weight. Four cases (17.4%) were weighing < 1.5kg; while 8 cases were weighing 1.5-2.5kg (34.8%) and 11 cases only were weighing > 2.5 kg (47.8 %).
As regard the clinical presentation, most of our cases were diagnosed postnatally. Eighteen of the cases (78.3 %) were diagnosed in the postnatal period and only 5 cases (21.7%) were diagnosed by antenatal diagnostic means.
The majority of postnatal clinical presentations were: respiratory distress, cyanosis, grunting, working alae nasi as well as intercostal retractions which indicated chest x-ray.
Approximately one third of the cases (7 cases) had cardiac anomalies. Ventricular septal defect (VSD) was the most common cardiac anomaly seen in our cases (4 cases).
The preoperative X-ray analysis showed the following: Most of the patients in our series were left sided (19 cases), with only 4 cases were right sided. Bilateral defects are absent. The gastric air bubble was easily visualized in all cases, 15 cases (65.2%) was present in the abdominal cavity and was present in the chest only in 8 cases.
Most of cases (82.6%) had the soft tissue shadow of the liver in the abdominal cavity. Only 4 cases (17.4%) had the soft tissue shadow of the liver in the chest.
The soft tissue shadow of the spleen in plain X-ray was more difficult to be visualized than the gastric air bubble and the soft tissue shadow of the liver. It could not be visualized in 8 cases (34.8%). However, it was visualized in the rest of the cases (15 cases); 12 cases (52.2%) had the soft tissue shadow of the spleen in the abdominal cavity and in 3 cases (13%) it was in the chest.