Bilateral congenital diaphragmatic hernias through the foramina of Bochdalek

Abstract

The occurrence of bilateral congenital diaphragmatic hernia is so rare that textbooks of general and pediatric surgery 1–3 fail to even mention the possibility of its existence. A review of the world's literature by Fitchett and Tavarez 4 in 1965 yielded only 9 cases plus one reported by them. Of these 10, only 2 were hernias through the foramina of Bochdalek; the remainder were hernias through the foramina of Morgagni. A review of the literature since 1965 failed to disclose further cases. This report then becomes the third of record. The first case of bilateral congenital Bochdalek herniation was reported by Bowers, McElin, and Dorsey in 1955. 5 Their patient was a 900 Gm. neonate whose duration of life was only 20 minutes. The sex and race of the child were not stated, but it was the result of a 35-week gestation in a 19-year-old primigravida. The presence of the hernias was not known until an autopsy was performed. It is not known whether or not a sac was present. The second case was reported by Fitchett and Tavarez 4 and represents the only known survivor with this condition. Their patient was a Negro male, born at term, weighing 2500 Gm. Both hernias had peritoneal sacs allowing viscera to herniate only 3 cm. into the pleural cavities.