Eventration of left hemi-diaphragm with left kidney in thorax – Congenital diaphragmatic hernia

AbstractCongenital diaphragmatic hernia (CDH) is a rare and severe disorder with a high mortality rate among infants. Unilateral renal agenesis (URA) is a relatively common congenital urinary malformation. Here, we present the case of a newborn infant with left CDH associated with ipsilateral renal agenesis. The male patient was born weighing 3.850 g through normal spontaneous vaginal delivery at 38 weeks and 6 days of gestational age at a maternity hospital. He was transferred to our neonatal intensive care unit due to respiratory distress with tachypnea, grunting and cyanosis after birth. A chest radiography indicated parts of the bowel in the thoracic cavity, consistent with CDH. Renal ultrasonography indicated no kidney structure on the left side and a 5.6 cm right kidney with normal echogenicity. Repair of the diaphragmatic hernia was performed three days after birth. Most of the colon, small bowel, stomach and spleen were located in the left pleural cavity, but the left kidney was not seen. Subsequent dimercaptosuccinic acid scintigraphy indicated non-visualized functional cortical uptake in the left kidney on day 13 after birth. Thus, we report the successful treatment of a patient with CDH accompanied by URA.

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A Case of Fatal Pulmonary Hypoplasia with Congenital Diaphragmatic Hernia, Thoracic Myelomeningocele, and Thoracic Dysplasia

American Journal of Perinatology Reports ◽

10.1055/s-0037-1615791 ◽

2017 ◽

Vol 07 (04) ◽

pp. e234-e237

Author(s):

Ai Ito ◽

Hideshi Fujinaga ◽

Sachiko Matsui ◽

Kumiko Tago ◽

Yuka Iwasaki ◽

...

Keyword(s):

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

Neonatal Intensive Care ◽

Pulmonary Hypoplasia ◽

Left Kidney ◽

Fatal Case ◽

Male Infant ◽

Skeletal Deformity ◽

Severe Scoliosis ◽

Severe Hydrocephalus

Background Congenital diaphragmatic hernia (CDH) is fatal in severe cases of pulmonary hypoplasia. We experienced a fatal case of pulmonary hypoplasia due to CDH, thoracic myelomeningocele (MMC), and thoracic dysplasia. This constellation of anomalies has not been previously reported. Case Report A male infant with a prenatal diagnosis of thoracic MMC with severe hydrocephalus and scoliosis was born at 36 weeks of gestation. CDH was found after birth and the patient died of respiratory failure due to pulmonary hypoplasia and persistent pulmonary hypertension of the newborn at 30 hours of age despite neonatal intensive care. An autopsy revealed a left CDH without herniation of the liver or stomach into the thoracic cavity, severe hydrocephalus, Chiari malformation type II, MMC with spina bifida from Th4 to Th12, hemivertebrae, fused ribs, deformities of the thoracic cage and legs, short trunk, and agenesis of the left kidney. Conclusion We speculate that two factors may be associated with the severe pulmonary hypoplasia: decreased thoracic space due to the herniation of visceral organs caused by CDH and thoracic dysplasia due to skeletal deformity and severe scoliosis.

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Gastric volvulus associated with congenital diaphragmatic hernia, wandering spleen, and intrathoracic left kidney: CT findings

Abdominal Imaging ◽

10.1007/s002610000171 ◽

2001 ◽

Vol 26 (3) ◽

pp. 306-308 ◽

Cited By ~ 36

Author(s):

G. Pelizzo ◽

M. A. Lembo ◽

A. Franchella ◽

A. Giombi ◽

F. D'Agostino ◽

...

Keyword(s):

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

Left Kidney ◽

Gastric Volvulus ◽

Wandering Spleen ◽

Ct Findings

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Obstructed Bochdalek hernia: a rare presentation of congenital diaphragmatic hernia in adulthood

International Surgery Journal ◽

10.18203/2349-2902.isj20193007 ◽

2019 ◽

Vol 6 (7) ◽

pp. 2617

Author(s):

Vikranth Suresh N. ◽

Sreeramulu P. N. ◽

Shivaprasad Gangadhar Savagave ◽

Sundeep Vogu

Keyword(s):

Emergency Department ◽

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

Respiratory Symptoms ◽

Exploratory Laparotomy ◽

Acute Onset ◽

Bochdalek Hernia ◽

Lateral Aspect ◽

Rare Presentation ◽

Left Hemi

Congenital diaphragmatic hernia (CDH) is usually diagnosed antenatally or during the initial few hours of life in newborns who present with respiratory distress. CDH presenting with intestinal obstruction in adulthood is very rare. We report a case of 28 year old male, who presented to emergency department, with acute onset of abdominal pain and breathlessness since 2 days. Patient was investigated and diagnosed to have Bochdalek hernia (BH), with herniation of intra-abdominal contents to thorax through the defect (3.5×4.5 cms) in postero-lateral aspect of left hemi-diaphragm with obstructive features of bowel. Patient underwent emergency exploratory laparotomy with reduction of contents and hernia repair. Patient recovered and remains well. High suspicion of BH should be done when patient presents with abdominal and respiratory symptoms even though it is very rare in adults.

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Congenital Diaphragmatic Hernia with Intrathoracic Renal Ectopia: Thoracoscopic Approach for a Complete Anatomical Repair

European Journal of Pediatric Surgery Reports ◽

10.1055/s-0039-3402741 ◽

2020 ◽

Vol 08 (01) ◽

pp. e74-e76

Author(s):

Colin Mizzi ◽

David Farrugia ◽

Muhammad S. Choudhry

Keyword(s):

Adrenal Gland ◽

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

Left Kidney ◽

Computed Tomography Scan ◽

Baby Girl ◽

Thoracoscopic Approach ◽

X Ray ◽

Chest X Ray ◽

Tomography Scan

AbstractCongenital diaphragmatic herniae (CDH) with associated intrathoracic ectopic kidneys are rare congenital anomalies, with a reported incidence of only 0.25%. The authors report a case of a 24-day-old baby girl who was diagnosed with a left-sided CDH on a chest X-ray taken for pneumonia. Computed tomography scan showed CDH hernia, containing small and large bowel and whole left kidney with adrenal gland. Thoracoscopic reduction in the bowel, kidney, and adrenal gland into the abdomen and primary closure of the defect was achieved with no complications. During investigation of the child, it was discovered that her maternal aunt had also had a left-sided congenital diaphragmatic hernia containing the kidney, which was treated via open surgery after birth; she subsequently developed renal cell carcinoma and required radical nephrectomy of that kidney during her third decade.

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