Right-Sided Bochdalek Hernia with Intrathoracic Ectopic Kidney in an Advanced-Age Adult: A Case Report

Onuk, Özkan; Taş, Tuncay; Şentürk, Aykut Buğra; Sinanoğlu, Orhun; Balcı, Melih; Çelik, Orçun; Nuhoğlu, Barış

doi:10.1159/000353100

Cited by 8 publications

(5 citation statements)

References 11 publications

(13 reference statements)

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“…He did not report any symptoms after 12 months [ 22 ]. In one further case, the patient refused any surgical repair and denied any problems 6 months later [ 25 ]. In the third case, symptoms resolved a few days after initial presentation in the hospital.…”

Section: Resultsmentioning

confidence: 99%

A systematic review on diagnostics and surgical treatment of adult right-sided Bochdalek hernias and presentation of the current management pathway

Ramspott

Jäger

Lechner

et al. 2021

Hernia

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Purpose Bochdalek hernia is a congenital diaphragmatic hernia. The incidence in adults is estimated around 0.17%. Right-sided hernias are much more seldom than left-sided ones because of faster closure of the right pleuroperitoneal canal and the protective effect of the liver. Due to its rarity, there have been no large prospective or retrospective studies following great need for evidence-based diagnostics and treatment strategies. In this systematic review, we evaluated the current evidence of diagnostics, treatment, and follow-up of adult right-sided Bochdalek hernias. Methods According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines a systematic literature review was conducted in PubMed and Cochrane library from 2004 to January 2021. The literature search included all studies with non-traumatic right-sided Bochdalek hernias. Literature on left- or both-sided, pregnancy-associated, pediatric, and other types of hernias were explicitly excluded. Quality assessment of the included studies was performed. Results Database search identified 401 records. After eligibility screening 41 studies describing 44 cases of right-sided non-traumatic Bochdalek hernias in adulthood were included for final analysis. Based upon the systematic literature review, the current diagnostic, therapeutic, and follow-up management pathway for this rare surgical emergency is presented. Conclusion This systematic review underlined that most studies investigating management of adult non-traumatic right-sided Bochdalek hernias are of moderate to low methodological quality. Hernias tend to occur more frequently in middle-aged and older women presenting with abdominal pain and dyspnea. A rapid and accurate diagnosis following surgical repair and regular follow-up is mandatory. High-quality studies focusing on the management of this rare entity are urgently needed.

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Section: Resultsmentioning

confidence: 99%

A systematic review on diagnostics and surgical treatment of adult right-sided Bochdalek hernias and presentation of the current management pathway

Ramspott

Jäger

Lechner

et al. 2021

Hernia

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“…The incidence of Bochdalek hernia associated with intrathoracic kidney is reported to be <0.25% [1] with most of the cases concerning the left side. The incidence of right-sided Bochdalek hernia is rare with 32 cases reported in medical literature so far and concomitant, right-sided intrathoracic kidney and Bochdalek hernia is even rarer with only two cases reported in adults [1,9], three cases in the children [10][11][12], and two prenatal cases thus far [13,14]. Through the foramen of Bochdalek, the kidney exits the retroperitoneal space and enters the thoracic cavity but not the pleural space.…”

Section: Discussionmentioning

confidence: 99%

“…The organs that are most frequently herniated are the omentum, the colon, the spleen, the kidney, and the pancreas on the left side and the liver on the right side. In very rare cases, ectopic intrathoracic kidney is reported to occur due to Bochdalek hernia [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

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

Kummari,

Ramadugu,

Ramadugu

et al. 2024

Cureus

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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.

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“…Nephrogenic rests can be subclassified into perilobar nephrogenic rests and intralobar nephrogenic rests, according to their location in relation to the renal lobe on histological examination. Occasionally, nephrogenic rests are found in ectopic sites, such as the inguinal canal [ 5 ], lumbosacral area [ 3 , 9 – 12 ], adrenal gland [ 13 ], thorax [ 14 , 15 ], colon [ 16 ] and heart [ 17 ]. There are two possible distinct fates for nephrogenic rests: to be an isolated developmental abnormality, or the early stage of a neoplastic process, with the latter being more clinically significant.…”

Section: Discussionmentioning

confidence: 99%

Extrarenal nephroblastomatosis in children: a report of two cases

Zhu

Wang

et al. 2014

BMC Pediatr

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BackgroundExtrarenal nephroblastomatosis is a rare entity which occurs in retroperitoneum and inguinal region predominantly. Here we report two cases of primary extrarenal nephroblastomatosis of Han Chinese in Asian in unusual locations, one is located in testis and paratestis, and the other is paraspinal cord.Case presentationPatient 1 was a 19-month-old boy with a hard and nodular mass adherent to the left testis in inguinal region. Patient 2 was a 9-month-old boy with a 1 × 0.7 × 0.4 cm mass in spinal canal at the midline thoracolumbar region. Histological examinations of the two patients after operations revealed extrarenall nephroblastomatosis with multiple nephrogenic foci, composed of immature glomeruli, tubules and blastemal cells.Then the patients were closely monitored without adjuvant chemotherapy, and has been alive and well without any recurrence for >6 months.ConclusionsMost nephrogenic rests remain subclinical, and thus, complete excision of the lesion with conservative treatment is recommended. Otherwise, nephrogenic rests are close associated with Wilms tumor and regular follow-up is required to ensure early detection of malignant transformation.

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Right-Sided Bochdalek Hernia with Intrathoracic Ectopic Kidney in an Advanced-Age Adult: A Case Report

Cited by 8 publications

References 11 publications

A systematic review on diagnostics and surgical treatment of adult right-sided Bochdalek hernias and presentation of the current management pathway

A systematic review on diagnostics and surgical treatment of adult right-sided Bochdalek hernias and presentation of the current management pathway

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

Extrarenal nephroblastomatosis in children: a report of two cases

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