Right-sided Bochdalek hernia with intrathoracic kidney

Area of Science:

• Pediatric Surgery
• Congenital Anomalies
• Thoracic Surgery

Background:

• Bochdalek hernias are typically congenital, occurring more frequently on the left side.
• Intrathoracic kidney is an exceptionally rare congenital anomaly, with limited documented cases.
• The co-occurrence of intrathoracic kidney and Bochdalek hernia is exceedingly uncommon, reported in less than 0.25% of cases.

Observation:

• A 22-month-old boy presented with recurrent pulmonary infections.
• Diagnostic imaging revealed a right-sided Bochdalek hernia containing dilated colon loops and the right kidney within the right hemithorax.
• This represents the second reported instance of a right Bochdalek hernia associated with an intrathoracic kidney.

Findings:

• Surgical exploration via thoracotomy confirmed the right Bochdalek hernia with intrathoracic kidney and colon.
• The hernia was successfully repaired through direct closure after repositioning the abdominal contents.
• The patient's clinical presentation and diagnostic findings highlight the rarity of this specific congenital combination.

Implications:

• This case underscores the importance of comprehensive diagnostic evaluation for congenital diaphragmatic hernias, especially when atypical presentations occur.
• Understanding the clinical correlations of rare congenital anomalies like right Bochdalek hernia with intrathoracic kidney is crucial for surgical planning and patient management.
• Further case reports and analysis are needed to better elucidate the pathophysiology and long-term outcomes associated with this unusual combination.