Perioperative management of diaphragmatic diseases in neonates and infants

Importance: Diaphragmatic diseases(DD) in neonates and infants are rare surgical cases involving the cardiopulmonary and digestive system, complicating perioperative management. Objectives: The study aims to describe the clinical presentations, radiological imaging, anesthesia and surgical technique of three types of DD; congenital diaphragmatic hernia(CDH), hiatal hernia (HH) and eventration of the diaphragm(ED). Methods: This was single-center case series in a tertiary referral and teaching hospital from July to August 2021. Three patients were presented, a 13 days old neonate with CDH, a one-month-old infant with HH and a two-month-old infant with ED. An institutional review board was obtained, and the PROCESS guidelines were used in writing. Results: Main clinical presentation was respiratory distress and vomiting since birth. Radiological imaging was essential to diagnose each case. CDH had more cardiopulmonary complications and more extended post-operative care in intensive care during the perioperative period. Conclusion: DD is a differential diagnosis in early-onset respiratory distress in neonates and infants with recurring infections and trouble feeding. Radiological examination is crucial in the diagnosis, and surgical treatment is favorable. CDH remains the most severe form of DD.