-2 :: Case - 9957 :: - Congenital diaphragmatic hernia
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Tx and Followup:
The diaphragmatic defect was repaired surgically and the right kidney returned to a more anatomic location.

Retrospective review of the prenatal anatomic screen of the fetus fails to demonstrate a diaphragmatic abnormality and the kidney was intra abdominal.

Additional Discussion:
An interesting coincidental finding in this patient was right-sided scimitar syndrome, which has an association with CDH.

Discussion Author: Justin Dodge

Congenital diaphragmatic hernia
1. Bochdalek (through posterior pleuroperitoneal foramen)
o usually diagnosed by prenatal ultrasound
o incidence 1 in 2-5000 live births
o 80-90% of congenital diaphragmatic hernias
o 80-90% on the left
o radiographic findings include
- large intrathoracic soft tissue mass of fluid or air-filled bowel loops
- paucity of bowel in the abdomen
o prognosis related to the degree hypoplasia of the ipsilateral and, in some cases also the contralateral, lung (50-70% mortality) and to associated anomalies of other organ systems
2. Morgagni (anteromedial)
o less than 10% of congenital diaphragmatic hernias
o most occur on the right
3. Eventration (usually right-sided)
o hypoplasia of the diaphragmatic musculature

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