Differential diagnosis of diaphragmatic hernia

Approach to the differential diagnosis of diaphragmatic hernia:

  • There are 2 types of congenital diaphragmatic hernia – Bochdalek and Morgagni. Because Bochdalek hernia overwhelmingly presents at birth, it is colloquially referred to as congenital diaphragmatic hernia
  • Bodhdalek hernia has its defect located posterolaterally and is diagnosed prenatally or presents at birth with respiratory distress. It rarely presents later in life.
  • Congenital diaphragmatic hernia once repaired can recur, so surveillance with CXR is recommended
  • Intrathoracic kidney is in the spectrum of Bochdalek hernia
  • Morgagni hernia has its defect located anteromedially and usually presents incidentally later in life on CXR
  • Diaphragmatic hernias can also occur post-traumatically or iatrogenically during chest or abdominal surgery