Congenital diaphragmatic hernia (A report on 5 cases)

Introduction: Congenital diaphragmatic hernia (CDH) is defined by the failure of all or part of the diaphragmatic dome to develop; this anomaly results in the presence of certain abdominal organs within the thoracic cavity during critical stages of fetal lung development. In 80% of cases, this involves the posterolateral portion of the left dome, known as a Bochdalek hernia.
Materials and Methods: The aim of our study was to conduct a retrospective analysis of five cases of congenital diaphragmatic hernia collected between January 1 2023, and December 31 2025, at the National Reference Center for Neonatology and Neonatal Intensive Care in Rabat Morocco.
Results: Among our patients, the sex ratio was 4 with a clear predominance of females. Diaphragmatic involvement is usually unilateral, with a preference for the left side in nearly 80 to 90% of cases. In our study, there were two cases of associated malformations (one case of trisomy 21 and one case of type 1 omphalocele with agenesis of the corpus callosum). None of the newborns had a prenatal diagnosis, and the clinical presentation was dominated by respiratory symptoms, with one patient diagnosed at 15 days of life with bronchiolitis. A chest X-ray is the key test for establishing the diagnosis; it was performed on all newborns and was highly suggestive of the diagnosis. A chest CT scan was performed on two patients, aided in the diagnosis, and provided insight into the herniated organs. All patients received pre- and postoperative resuscitation to optimize their care. Surgical treatment which involved reducing the herniated organs and closing the diaphragmatic defect was performed on four patients; one patient died before the surgery. The short-term outcome was favorable for all patients who underwent surgery.
Conclusion: Congenital diaphragmatic hernia is a rare but serious condition. The prognosis remains poor and depends on the presence and severity of pulmonary hypoplasia and the presence of associated congenital malformations.