Update

I saw my nephew today, and he is doing very well - it was wonderful to see him with colour in his cheeks - playing with his toys and smiling. His true diagnosis is a hiatus hernia that perforated his oesophagus - this is what complicated the original operation. Thank you all for your prayers!

Update

I have been away for a short break with family and plenty has happened since I last blogged.

My nephew is having his operation today and I will get phone call as soon as there is anything to update me on.
He has had an infection in his main feed tube and we thought this was going to put back his operation again..but antibiotics were given which seems to have done the trick.

Now to what's wrong with him.

He has a CONGENITAL DIAPHRAGMATIC HERNIA.

He has a problem called "Congenital Diaphragmatic Hernia" or CDH. Congenital means "born with" and a hernia is a problem where something goes through a hole it is not supposed to. The hole is in his diaphragm. The diaphragm is a muscle that helps us to breathe and keeps the organs in the abdomen from going into the chest cavity. This is a picture of how things are normally.
















When he was very small (early in the pregnancy), there was a hole in the diaphragm. This is normal, but the hole usually closes by the end of the third month of pregnancy. His case, the hole stayed open. This allowed some of the intestines to go into the chest cavity. Since the intestines were in the chest cavity and not where they were supposed to be, the lungs could not grow in the normal space that they need (they had to share the space with the intestines). This means that the lungs are smaller than they should be. The intestines can also push on the other lung and keep it from growing fully and can sometimes keep the heart from growing normally. This is a picture of how things look in a baby with a left-sided diaphragmatic hernia.














These pictures show clearly how the body has not been able to develop properly.

How is a diaphragmatic hernia repaired?

Diaphragmatic hernias are repaired in an operation under general anaesthetic (so that he is deeply asleep), which can last between one to two hours. The surgeons will only carry out the operation once the baby is stable on a ventilator.

What does the operation involve?

During the operation, the surgeon will move his intestine back into the abdomen and repair the hole in their diaphragm. Sometimes, the surgeon may need to use a ‘patch’ of special material to close this hole, but this will not cause any problems in the long term. His intestine has become twisted while it is in the chest (which is not uncommon), the surgeon will correct this during the same operation. If his intestine has been damaged by being squashed in the chest, the surgeon may remove a damaged portion.

Are there any risks?

All the doctors who perform this operation have had lots of experience and will minimise the chance of problems occurring.
All operations carry a small risk of bleeding, during or afterwards. Every anaesthetic carries a risk of complications, but this is very small. His anaesthetist is a very experienced doctor who is trained to deal with any complications.
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I wanted to share this information as looking into it and finding things out has really helped me.