Bochdalek Hernia
Michael P. Federle, MD, FACR
Amir A. Borhani, MD
Key Facts
Imaging
More common on left side (˜ 80%)
In adults: Usually contains retroperitoneal fat ± kidney
Best imaging tools: Multiplanar CT or MR
Coronal and sagittal reformats are very helpful to better delineate defect
CECT is helpful for assessment of complications (incarceration, strangulation)
Top Differential Diagnoses
Mediastinal and thoracic masses
e.g., mediastinal lipoma/liposarcoma, cystic adenomatoid malformation, tumors of diaphragm, pericardial mass/cyst
Pulmonary and pleural lesions
e.g., atelectasis, pneumonia, abscess, pleural effusion, pneumatocele
Pathology
Congenital defect in posterolateral diaphragm
Failure in closure of pleuropulmonary canal
Fetal communication between thorax and abdomen
Rarely secondary to trauma
Clinical Issues
Usually of no clinical significance in adults
Associated with chronic obstructive lung disease
High mortality in neonatesRelated posts:
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
