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DOI: 10.1055/s-0036-1593765
Hernia Sac Presence Portends Better Survivability of Isolated Congenital Diaphragmatic Hernia with “Liver-Up”
Publication History
23 May 2016
14 September 2016
Publication Date:
25 October 2016 (online)
![](https://www.thieme-connect.de/media/ajp/201705/lookinside/thumbnails/10-1055-s-0036-1593765_160234-1.jpg)
Abstract
Objective The objective of this study was to investigate the prognostic value of a hernia sac in isolated congenital diaphragmatic hernia (CDH) with intrathoracic liver herniation (“liver-up”).
Study Design A retrospective study from the single tertiary center. Isolated “liver-up” CDH neonates referred to our institution between 2000 and 2015 were reviewed for the presence or absence of a hernia sac. Association between the presence of a hernia sac and survival was assessed.
Results Over the study period, there were 29 isolated CDH patients with “liver-up” who were treated, 7 (24%) had a sac, and 22 (76%) did not. Demographics were similar between groups. However, disease acuity, assessed from lower Apgar scores (p = 0.044), lower probability of survival (p = 0.037), and lower admission oxygenation (p = 0.027), was higher in neonates without a sac. Hospital survival was significantly higher for those with sac compared with those without (7/7, 100 vs. 7/22, 32%, p = 0.002).
Conclusion The presence of a hernia sac may be associated with better survival for isolated “liver-up” CDH. As the presence of sac can be prenatally detected, it may be a useful marker to aid perinatal decision making.
Keywords
congenital diaphragmatic hernia - hernia sac - liver-up - mortality - outcome - risk assessment - survival* These authors contributed equally to this article.
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