[Delayed appearance of left Bochdalek hernia disclosed by intrathoracic gastric perforation]

Late onset congenital diaphragmatic hernia is a rare condition that is difficult to diagnose. Complications such as intestinal obstruction and digestive perforation may occur. A previously healthy three year-old girl was admitted to hospital with dehydration, shock, and ketoacidosis. A chest X-ray film showed a left hydropneumothorax with an indefinable left diaphragm, that was confirmed by ultrasonography. Hexabrix introduced through a nasogastric tube showed opacification of the left hemithorax attributed to an intrathoracic gastric perforation. She recovered after surgery. Gastrointestinal complications of delayed congenital diaphragmatic hernia must be promptly recognized since surgery should not be delayed.