Diagnosis: Bochdalek (Pleuroperitoneal) Hernia
Findings on Imaging:
- Imaging studies such as chest x-ray or CT may show a Bochdalek hernia, which is a congenital diaphragmatic hernia that allows abdominal contents to herniate into the thorax.
- On chest x-ray, a Bochdalek hernia may appear as a mass or opacity in the thorax that is separate from the mediastinum or lung parenchyma.
- On this particular case, the radiograph demonstrates bowel containing contrast within the chest, within the pleural cavity consistent with a pleuroperitoneal hernia.
- On CT, a Bochdalek hernia may show as a defect in the diaphragm with herniation of abdominal organs into the thorax, causing displacement of adjacent structures.
Next Steps in Management:
- Management of a Bochdalek hernia depends on the extent and severity of the herniation and associated symptoms.
- Treatment options may include observation, surgical repair of the hernia, and supportive care.
- Regular imaging follow-up is recommended to monitor for changes in the size and position of the hernia.
Key Take Away Points:
- Bochdalek hernia is a congenital diaphragmatic hernia that allows abdominal contents to herniate into the thorax.
- Imaging studies such as chest x-ray or CT can help diagnose a Bochdalek hernia by showing a mass or opacity in the thorax that is separate from the mediastinum or lung parenchyma.
- Treatment of a Bochdalek hernia may include observation, surgical repair, and supportive care.
- Regular imaging follow-up is recommended to monitor for changes in the size and position of the hernia.
- Pleuroperitoneal hernias typically occur posteriorly and are a result of a posteriorly located defect when there is a failure in closing the pleuroperitoneal membrane closure while in utero. Bowel, retroperitoneal structures may prolapse through the defect into the pleural space.
Credi: Case submtited by Dr. Saeed Rad MD to radRounds Radiology Network
