Three infants were found to have infradiaphragmatic masses by prenatal ultrasound. Postnatal imaging studies confirmed the presence of these masses, which were suspected of being intra-abdominal malignancies (neuroblastoma). The other principal differential diagnosis was extralobar pulmonary sequestration (EPS). Intraoperative findings were consistent with EPS, which was confirmed by histologic examination. We present these three infants, review the literature, and discuss the evaluation and treatment of infradiaphragmatic EPS.

Paraesophageal hernias in children are rare, and can occur congenitally or be acquired. Acquired cases most often follow anti-gastroesophageal reflux surgery, or less commonly trauma. In children, elective repair is encouraged at the time of diagnosis to prevent future life-threatening complications.