Cureus

. 2024 May 19;16(5):e60598.

 doi: 10.7759/cureus.60598. eCollection 2024 May. https://pubmed.ncbi.nlm.nih.gov/38894760/

Right-Sided Ectopic Intrathoracic Kidney Associated With Symptomatic Bochdalek Hernia in an Adult Indian Female: Case Report and Review of Literature

Satyanarayana Kummari ¹, Rithika Ramadugu ², Sameera Ramadugu ³, Mustafa Hussain Ansari ⁴, Saad Ali Ibrahim ⁴

Affiliations expand

• PMID: 38894760
• PMCID: PMC11184630
• DOI: 10.7759/cureus.60598

Abstract

Bochdalek hernia is an inherited posterior lateral defect in the diaphragm that allows the abdominal organs to herniate into the thoracic cavity. In addition to being the most prevalent variety of congenital diaphragmatic hernia (CDH), it is also the type that is observed on the left hemithorax the majority of the time. Ectopic kidney is an uncommon condition, and the occurrence of ectopic intrathoracic kidney is even more uncommon, accounting for only a few of all the cases of renal ectopias. The occurrence of intrathoracic kidney associated with Bochdalek hernia is infrequent among adult individuals and is typically an incidental finding. A 52-year-old obese female patient presented to the pulmonology outpatient unit and reported experiencing the symptoms of coughing, wheezing, and difficulty in breathing since three years. A chest radiograph revealed an elevated dome of the diaphragm on the right side. A computed tomography (CT) of the chest revealed a defect in the posterior aspect of the right hemi-diaphragm with herniation of the right kidney and retroperitoneal fat into the right hemi-thorax. CT urography showed normal size and enhancement of the intrathoracic kidney with prompt excretion of contrast into the pelvicalyceal system. With regard to the small size of the hernia and considering the absence of complications on CT urography, a conservative treatment was proposed to the patient. The patient was followed up every year. There was no occurrence of renal complications during the follow-up period. When evaluating patients with ‘elevated hemi-diaphragm’ or thoracic ‘mass’, it is essential to check for the presence of intrathoracic kidney to avoid undesirable surgical procedures and image-guided biopsies.

Keywords: bochdalek hernia; congenital diaphragmatic hernia (cdh); ectopic kidney; elevated diaphragm; intrathoracic kidney.

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