Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology
The patient was a full term female born with a right-sided congenital chest mass that was diagnosed on prenatal ultrasound as a diaphragmatic hernia. Immediately after birth she was maintained on conventional ventilation, but soon afterwards her respiratory status worsened and she then required placement on veno-veno Extra Corporeal Membrane Oxygenation (ECMO).
Clinical Physical Exam:
The infant was in marked respiratory distress.
Clinical Differential Diagnosis:
Diaphragmatic Hernia, Cystic Adenomatoid Malformation, Congenital Lobar Emphysema
An AP chest film obtained at birth demonstrated an opacified right hemithorax with several air filled structures within it.
Imaging Differential Diagnosis:
On the fourth day of life the hernia was repaired. The abdomen was entered through a right subcostal incision. A large diaphragmatic defect was identified. The diaphragm had a large anterior leaflet and a smaller posterior leaflet. The entire liver except for the left lateral segment was in the thoracic cavity. A large quantity of small intestine as well as the upper aspect of the right kidney was also in the thoracic cavity. The diaphragm defect was repaired with the addition of a Gore-Tex patch measuring 4 x 5 cm.
Diaphragmatic Hernia, Bochdalek, Right Sided
Follow-up and Prognosis:
The patient had an uncomplicated post-operative course. Imaging studies obtained at 1 year of age showed a typical post operative appearance.
Case 11, Case 17, Case 22, Case 26
Please send us comments by filling out our Comment Form.
All contents copyright © 1992-2014 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.
"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.
Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.
Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.
The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.
This site complies with the HONcode standard for trustworthy health information: