Differential diagnosis of diaphragmatic hernia

• Morgagni hernia
• Bochdalek hernia
• Delayed presentation of congenital diaphragmatic hernia
• Recurrent congenital diaphragmatic hernia
• Intrathoracic kidney
• Post-traumatic diaphragmatic hernia
• Post-operative 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