Congenital Conditions Affecting the Lungs (Pediatric)

The congenital conditions affecting the lungs described in this section are:

  • Congenital diaphragmatic hernia 
  • Tracheoesophageal fistula 

What is congenital diaphragmatic hernia (CDH)?

This condition is a defect or opening in the baby’s diaphragm, the muscle that separates the chest cavity from the abdominal cavity. The opening allows some of the organs normally found in the abdomen to move up into the chest. These organs can crowd the lungs, limiting their grow and development.

Many infants with CDH are diagnosed before birth. However, the degree of breathing impairment is not known until after delivery. Symptoms can range from mild to severe.

Infants with CDH usually have a breathing tube inserted right after birth and are then placed on a ventilator (breathing machine). Once your child’s breathing is supported and under control—generally in the first weeks of life—pediatric surgeons can repair the CDH. While treatments for CHD have advanced, some babies may continue to have breathing or feeding problems after surgery. 

In very severe cases, a baby does not get enough oxygen may be put on a by-pass system called ECMO (Extracorporeal Membrane Oxygenator) that takes over for the baby's heart and lungs. Our physicians are pioneers in ECMO and have one the largest programs in the world, providing advanced respiratory support.

What is tracheoesophageal fistula (TEF)? 

This condition is an abnormal connection between the esophagus (the tube leading from the mouth to the stomach) and the trachea (the tube leading from the throat to the lungs). Normally, the esophagus and the trachea are separate structures. When there is an abnormal communication between the esophagus and the trachea, the infant may have breathing difficulties or develop an infection (pneumonia).

TEF often occurs with another defect known as Esophageal Atresia (EA). In EA, the esophagus does not form properly before birth. In most cases, the upper esophagus ends abruptly and does not connect with the lower esophagus and stomach.

TEF and EA can be corrected with surgery.