High apical insertion of the right diaphragm in an infant with right-sided Bochdalek diaphragmatic hernia

We report the case of a newborn full-term infant who presented to our service on the first day of life with a right-sided Bochdalek congenital diaphragmatic hernia associated with a high apical insertion of the right hemidiaphragm at the level of the second rib. This resulted in incarceration of the left lobe of the liver within the right hemithorax, but minimal pulmonary hypoplasia. A search of the literature failed to show a previous report of this variant of a duplication of the diaphragm in conjunction with a congenital diaphragmatic hernia. The approach taken for diaphragmatic reconstruction and closure of the defect is described.