Congenital Diaphragmatic Hernia in Neonates: Variations in Umbilical Catheter and Enteric Tube Position
- 1 July 2000
- journal article
- Published by Radiological Society of North America (RSNA) in Radiology
- Vol. 216 (1), 112-116
- https://doi.org/10.1148/radiology.216.1.r00jl13112
Abstract
To evaluate anatomic variations of support apparatus position on radiographs obtained in neonates with congenital diaphragmatic hernia (CDH). The authors evaluated radiographs obtained in 71 neonates with CDH to determine whether nasogastric tubes, umbilical venous catheters, and umbilical arterial catheters deviated from their expected anatomic course. The relationship between deviation patterns and hernia contents was evaluated. Sixty-eight neonates-54 with left-sided CDH and 14 with right-sided CDH-had a nasogastric tube. The tubes in 21 patients with left-sided CDH had a normal anatomic course at radiography. Nineteen of these patients did not have stomach in the hernia. In 13 patients, the tip of the nasogastric tube was lodged at the esophagogastric junction. In 17 patients, the tube was in the left hemithorax. In all 30 of these patients, the stomach was within the CDH. All nasogastric tubes in the 14 patients with right-sided CDH had leftward deviation. Thirty-seven patients-27 with left-sided CDH and 10 with right-sided CDH-had umbilical venous catheters. The catheters in 12 patients with left-sided CDH had apex leftward convexity. The umbilical venous catheter in eight patients with right-sided CDH had rightward shift; all eight patients had liver herniation. The positions of nasogastric tubes and umbilical venous catheters vary in several predictable patterns in neonates with CDH. Knowledge of these variations may be helpful for supporting the diagnosis of CDH in unclear cases and thus avoiding unnecessary apparatus adjustments, and for predicting hernia contents.Keywords
This publication has 13 references indexed in Scilit:
- Correlation between findings on chest radiography and survival in neonates with congenital diaphragmatic hernia.American Journal of Roentgenology, 1999
- Localized radiolucent chest lesions in neonates: causes and differentiation.American Journal of Roentgenology, 1999
- Anatomic study of the umbilical vein and ductus venosus in human fetuses: ultrasound application in prenatal examination of left congenital diaphragmatic herniaSurgical and Radiologic Anatomy, 1998
- Prenatal Color and Pulsed Doppler Sonographic Documentation of Intrathoracic Umbilical Vein and Ductus Venosus, Confirming Extensive Hepatic Herniation in Left Congenital Diaphragmatic HerniaAmerican Journal of Perinatology, 1996
- Congenital diaphragmatic hernia — A review of pre- and postoperative chest radiologyClinical Radiology, 1993
- Evaluation of umbilical catheter and tube placement in premature infants.RadioGraphics, 1991
- Congenital diaphragmatic hernia: the prognostic significance of the site of the stomachThe British Journal of Radiology, 1987
- A preoperative X-ray scoring system for risk assessment of newborns with congenital diaphragmatic herniaJournal of Pediatric Surgery, 1984
- ROENTGENOLOGIC FEATURES OF UMBILICAL VASCULAR CATHETERIZATION IN THE NEWBORNAmerican Journal of Roentgenology, 1971
- THE ROLE OF PULMONARY HYPOPLASIA IN THE PROGNOSIS OF NEWBORN INFANTS WITH DIAPHRAGMATIC HERNIA AND EVENTRATIONAmerican Journal of Roentgenology, 1968