Congenital posterolateral defect in the right side of the diaphragm

The infant born with a posterolateral defect in the right side of the diaphragm may appear normal at birth. His abdominal viscera may be normally located; the right side of the diaphragm may seem to be intact. Later, part of the liver may herniate. As it does, it displaces the lower part of the right lung, and hepatic flexure follows into a high posterior position in the right upper quadrant of the abdomen. Rarely, obstruction of portal and hepatic venous flow at the hernial ring may cause liquid to accumulate in the right side of the chest. At any time the liver may resume its interrupted passage. Increase in herniation will quickly make the patient sicker.