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Radiology General 562d029e

In X-ray, loops of bowel on left side of hemithorax and shift of hea shadow:

A
Eventration of diaphragm
B
Foraman of bochdalek hernia
C
Morganian hernia
D
Any of the above
High-Yield Explanation
D i.e. Any of above Bochdalek HerniaQ Most common diaphragmatic hernia in children Through persistent posterior pleuro-peritoneal canalQ 75% left sidedQ Presents with: - respiratory distressQ - air filled loop in thoraxQ - scaphoid abdomenQ - associated with dextrocardiac & malrotation of bowel. Morgagnian hernia Rare Anteriorly placed hernia with the defect between sternal & costal attachments of diaphragm Mostly right sidedQ Mostly asymptomatic, so may not be diagnosed until adulthood. Eventration of diaphragm An abnormally elevated position of one or both hemi diaphragm from paralysis or atrophy of the muscle fibers Right sidedQ is more common Most are minor, transitory, local diaphragmatic elevations, found incidently within the first few years of life & disappears with age Paradoxical respiration is treated by plication of redundant diaphragm; to minimize paradoxical movements & mediastinal shift. Bochdalek hernia is mostly left sided (but not always). Morgagnian hernia & Eventration of diaphragm are mostly right sided (but not always).

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