Obstet Gynecol Sci.  2016 Jan;59(1):58-61. 10.5468/ogs.2016.59.1.58.

Impaction of an intrathoracic kidney acted as a shield against herniation of the abdominal viscera in a case of right congenital diaphragmatic hernia

• Jeong BD
• Ahn SH
• Song JW
• Shim JY
• Lee MY
• Won HS
• Lee PR
• Kim A

• KMID: 2152646
• DOI: http://doi.org/10.5468/ogs.2016.59.1.58

Abstract

We describe a case of an intrathoracic kidney combined with right congenital diaphragmatic hernia (CDH) that was diagnosed at 32 weeks of gestation. Although it has been well established that a right CDH shows a poorer outcome than a left CDH, our present case showed a good outcome because there was no herniation of other abdominal viscera, except for the right kidney. Our findings in this case indicate that impaction of the intrathoracic kidney may act as a 'shield' against further herniation of other abdominal viscera into the thoracic cavity.

Keyword

Congenital diaphragmatic hernia; Ectopic kidney; Ultrasonography

MeSH Terms

Hernia, Diaphragmatic*
Kidney*
Pregnancy
Thoracic Cavity
Ultrasonography
Viscera*

Figure

• 

  Fig. 1 Ultrasonographic findings for the study patient at 32 weeks of gestation. (A) Parasagittal view of the fetus showing a mixed echogenic mass (RK) behind the right atrium (RA) of the fetal heart. The fluid-filled stomach (St) was in a normal position. (B) Subcostal 4-chamber view of the fetal heart (Ht) showing a mesocardia, with rotation of the heart and its apex located in the mid-thorax. A mixed echogenic right kidney was located behind the right side of the fetal heart.

• 

  Fig. 2 By postnatal computed tomography, through the right congenital diaphragmatic defect, a posterolateral herniated right kidney (RK) was observed in the neonatal chest and a right renal artery (black arrows) was stretched to feed the intrathoracic kidney.

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