Right congenital diaphragmatic hernia: Four cases and literature review

Abstract

Background: Left-sided Bochdalek congenital diaphragmatic hernia (CDH) is the most common type of CDH. The right-sided Bochdalek CDH is rare and usually contains only the liver as its content. We describe four children with right CDH managed at our institution over 3 years. Materials and Methods: We present a retrospective analysis of four patients with right CDH managed at our institution from 2012 to 2015 with respect to age at presentation, sex, presenting symptoms, investigations, associated anomalies, management, and outcome. Results: The average age at presentation was 1.5 years, with range being 5 days to 4 years. The three older children presented with a history of frequent respiratory tract infections. The neonate was a preterm low-birth weight baby and had respiratory distress since birth. A chest radiograph suggested right pneumothorax for which intercostal chest drain insertion was done. A repeat chest X-ray showed suspicion of right-sided CDH which was confirmed on computerized tomography. All four patients underwent right thoracotomy with repair of the CDH. The neonate expired on the 4th postoperative day. The other three children had an uneventful postoperative recovery. Conclusion: Right-sided CDH is rare and has varied presentations and poorer outcome.