Presentation
Recurrent chest infection without response to treatment. No history of trauma.
Patient Data
There is a large defect in the posterolateral aspect of the left hemi-diaphragm with resultant herniation of bowel loops associated with multiple edematous mesenteric lymph nodes. Constricted vessels in the left upper quadrant of the abdomen. No evidence of bowel obstruction or ischemia.
No herniation of the stomach, spleen or left kidney.
Evidence of lobar collapse/hypoplasia of underlying left lung is seen. No significant mediastinal shift towards the right is noted.
Few patches of air-space opacification is noted in left upper lobe.
Minimal pleural effusion on left side is seen.
Case Discussion
Age of the patient and CT features are more in favor of congenital diaphragmatic hernia (Bochdalek) as described above. Edematous lymph nodes suggest impairment of venous and lymphatic drainage.
Co-contributor Dr, Anwar-ul-Haq Zadaran.
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