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Bochdalek Hernia
Aletta Ann Frazier, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Posterior diaphragmatic hernia
              • Definitions

                • Bochdalek foramen: Posterior diaphragmatic defect
                  • Between lateral arcuate ligament and posterolateral 12th rib attachment
                • Intrathoracic herniation of abdominal contents
                  • Age, chronic obstructive pulmonary disease, and obesity may promote herniation

              IMAGING

              • General Features

                • Radiographic Findings

                  • Fluoroscopic Findings

                    • CT Findings

                      • MR Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Gross Pathologic & Surgical Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Sharma R et al: Routes of transdiaphragmatic migration from the abdomen to the chest. Radiographics. 40(5):1205-18, 2020
                                          2. Black MC et al: Innovative and contemporary interventions of diaphragmatic disorders. J Thorac Imaging. 34(4):236-47, 2019
                                          3. Koo CW et al: The breadth of the diaphragm: updates in embryogenesis and role of imaging. Br J Radiol. 91(1088):20170600, 2018
                                          4. Uhlich R et al: Diagnosis of diaphragm injuries using modern 256-slice CT scanners: too early to abandon operative exploration. Trauma Surg Acute Care Open. 3(1):e000251, 2018
                                          5. Hammer MM et al: Traumatic injuries of the diaphragm: overview of imaging findings and diagnosis. Abdom Radiol (NY). 42(4):1020-7, 2017
                                          6. Nason LK et al: Imaging of the diaphragm: anatomy and function. Radiographics. 32(2):E51-70, 2012
                                          7. Sandstrom CK et al: Diaphragmatic hernias: a spectrum of radiographic appearances. Curr Probl Diagn Radiol. 40(3):95-115, 2011
                                          8. Kinoshita F et al: Late-presenting posterior transdiaphragmatic (Bochdalek) hernia in adults: prevalence and MDCT characteristics. J Thorac Imaging. 24(1):17-22, 2009
                                          9. Roberts HC: Imaging the diaphragm. Thorac Surg Clin. 19(4):431-50, v, 2009
                                          10. Ottenheijm CA et al: Diaphragm adaptations in patients with COPD. Respir Res. 9:12, 2008
                                          11. Eren S et al: Diaphragmatic hernia: diagnostic approaches with review of the literature. Eur J Radiol. 54(3):448-59, 2005
                                          12. Mullins ME et al: Imaging of incidental Bochdalek hernia. Semin Ultrasound CT MR. 26(1):28-36, 2005
                                          13. Mullins ME et al: Prevalence of incidental Bochdalek's hernia in a large adult population. AJR Am J Roentgenol. 177(2):363-6, 2001
                                          14. Panicek DM et al: The diaphragm: anatomic, pathologic, and radiologic considerations. Radiographics. 8(3):385-425, 1988
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Synonyms

                                                        • Posterior diaphragmatic hernia
                                                      • Definitions

                                                        • Bochdalek foramen: Posterior diaphragmatic defect
                                                          • Between lateral arcuate ligament and posterolateral 12th rib attachment
                                                        • Intrathoracic herniation of abdominal contents
                                                          • Age, chronic obstructive pulmonary disease, and obesity may promote herniation

                                                      IMAGING

                                                      • General Features

                                                        • Radiographic Findings

                                                          • Fluoroscopic Findings

                                                            • CT Findings

                                                              • MR Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Sharma R et al: Routes of transdiaphragmatic migration from the abdomen to the chest. Radiographics. 40(5):1205-18, 2020
                                                                                  2. Black MC et al: Innovative and contemporary interventions of diaphragmatic disorders. J Thorac Imaging. 34(4):236-47, 2019
                                                                                  3. Koo CW et al: The breadth of the diaphragm: updates in embryogenesis and role of imaging. Br J Radiol. 91(1088):20170600, 2018
                                                                                  4. Uhlich R et al: Diagnosis of diaphragm injuries using modern 256-slice CT scanners: too early to abandon operative exploration. Trauma Surg Acute Care Open. 3(1):e000251, 2018
                                                                                  5. Hammer MM et al: Traumatic injuries of the diaphragm: overview of imaging findings and diagnosis. Abdom Radiol (NY). 42(4):1020-7, 2017
                                                                                  6. Nason LK et al: Imaging of the diaphragm: anatomy and function. Radiographics. 32(2):E51-70, 2012
                                                                                  7. Sandstrom CK et al: Diaphragmatic hernias: a spectrum of radiographic appearances. Curr Probl Diagn Radiol. 40(3):95-115, 2011
                                                                                  8. Kinoshita F et al: Late-presenting posterior transdiaphragmatic (Bochdalek) hernia in adults: prevalence and MDCT characteristics. J Thorac Imaging. 24(1):17-22, 2009
                                                                                  9. Roberts HC: Imaging the diaphragm. Thorac Surg Clin. 19(4):431-50, v, 2009
                                                                                  10. Ottenheijm CA et al: Diaphragm adaptations in patients with COPD. Respir Res. 9:12, 2008
                                                                                  11. Eren S et al: Diaphragmatic hernia: diagnostic approaches with review of the literature. Eur J Radiol. 54(3):448-59, 2005
                                                                                  12. Mullins ME et al: Imaging of incidental Bochdalek hernia. Semin Ultrasound CT MR. 26(1):28-36, 2005
                                                                                  13. Mullins ME et al: Prevalence of incidental Bochdalek's hernia in a large adult population. AJR Am J Roentgenol. 177(2):363-6, 2001
                                                                                  14. Panicek DM et al: The diaphragm: anatomic, pathologic, and radiologic considerations. Radiographics. 8(3):385-425, 1988