Diaphragmatic hernia

Case contributed by Ian Bickle
Diagnosis certain


A middle aged man presents with mild shortness of breath. He has been treated for 'dextrocardia' for several years.

Patient Data

Age: 41
Gender: Male

Huge left diaphragmatic hernia with spleen, splenic flexure, small bowel and vast amounts of mesentery in the thoracic cavity.

The heart is displaced to the right.  

Remenant left lung.

Incidental right apical lung mass.

Case Discussion

Gigantic diaphragmatic hernia.  

The defect is posteriorly and the diaphragmatic hernia huge  - this is a Bochdalek hernia, which was uncorrected from birth (parental refusal for surgical consent).

Left lung hypoplasia has occurred despite a normal left main bronchus.  Huge midline shift.


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