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Congenital diaphragmatic hernia

Case contributed by Prashant Mudgal
Diagnosis certain

Presentation

Young child presented with breathlessness, recurrent chest infections.

Patient Data

Age: 1.5 year
Gender: Male
x-ray

There is a mass lesion with lucent areas within, seen in the right lower zone in the supradiaphragmatic and paracardiac region, later on filling of lesion with barium suggesting herniation of intestinal loops most likely hepatic flexure and transverse colon, into thorax through a diaphragmatic defect. 

Imaging features are suggestive of Morgagni hernia.

Case Discussion

Congenital diaphragmatic hernias are the most common diaphragmatic anomalies. More than 90% of CDHs are Bochdalek hernia rest are Morgagni hernia.

In this case the bowel loops are herniating on the right side, the age of presentation is more than 1 year and size of herniated mass is smaller which is commonly seen with Morgagni hernia in contrast to Bochdalek hernia which is left sided and commonly seen in neonates and infants presenting with respiratory distress and large left sided lung mass on CXR.

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