#case0903

[wetread]

Season 9 Case 3

Hx: Chest pain 

Diagnosis?

Answer: Bochdalek Hernia 

 Large round opacity right lung base. 

On frontal does NOT obscure anterior diaphragm or R heart border - ie posterior/RLL 

On lateral DOES "obscure" entire posterior R diaphragm

-congenital defect in posterior diaphragm attachment 

- Can be either side (classic =L side in symptomatic infantslung hypoplasia, but R m/c in adults?) 

- typically only fat but ~25% can contain abd organs 

 Hint: Bochdalek = Back