An Asymptomatic Intrathoracic Kidney Secondary to a Bochdalek Hernia in a Geriatric Patient

A Bochdalek hernia is a congenital defect that permits abdominal organs to herniate into the thoracic cavity. While commonly diagnosed in neonates due to symptomatology, it is often found incidentally in adults. The case presents an 84-year-old male from a skilled nursing facility complaining of left-sided chest pain radiating to the left shoulder, accompanied by shortness of breath and nausea. Initially worked up for an acute coronary cause or pulmonary embolism, imaging revealed an incidental right-sided Bochdalek hernia with intrathoracic displacement of the right kidney. Given the absence of gastrointestinal or pulmonary symptoms, the patient was conservatively managed. While surgical repair is preferred for symptomatic Bochdalek hernias in adults, conservative management is a viable option for stable patients. This case highlights the importance of incidental imaging findings in guiding clinical decision-making and patient-focused care.