Diaphragmatic hernia—congenital or acquired—occurs when abdominal organs herniate through a defect in the diaphragm into the chest. Clinical expression depends on patient age, defect size, and the amount of herniated viscera. Respiratory distressTachypnea, dyspnea, cyanosis, and reduced or absent breath sounds on the affected side are the cardinal neonatal signs. Mediastinal shift may produce a barrel-shaped chest and displaced heart sounds . Feeding-related eventsInfants often exhibit feed refusal, drooling, or vomiting because the herniated stomach or bowel is compressed; older children or adults may report post-prandial shortness of breath that improves on standing or walking . Chest or epigastric discomfortAdults... Learn more