Left-Sided Intra-thoracic Ectopic Kidney With Symptomatic Bochdalek Hernia: A Case Report

Area of Science:

• Medical Imaging
• Thoracic Surgery
• Pediatric Surgery

Background:

• Bochdalek hernia (BH) is the most common congenital diaphragmatic hernia (CDH), allowing abdominal contents into the chest.
• Intra-thoracic ectopic kidney is an exceptionally rare condition, particularly in adults with BH.
• This case highlights the infrequent co-occurrence of these two conditions in adult patients.

Observation:

• A 51-year-old male presented with chronic cough, wheezing, and dyspnea.
• Imaging revealed a left-sided Bochdalek hernia with herniation of the left kidney into the hemithorax.
• CT urography confirmed a normally functioning intra-thoracic ectopic kidney.

Findings:

• The patient's intra-thoracic ectopic kidney was asymptomatic and functioning normally.
• The Bochdalek hernia was small, and the ectopic kidney showed no concerning abnormalities on CT urography.
• Conservative management was recommended due to the benign presentation.

Implications:

• Recognizing intra-thoracic kidneys in patients with thoracic masses or elevated hemidiaphragms is crucial.
• This awareness can prevent unnecessary invasive procedures like biopsies or surgery.
• Early identification and conservative management are key for asymptomatic intra-thoracic ectopic kidneys associated with Bochdalek hernias.