Impaction of an intrathoracic kidney acted as a shield against herniation of the abdominal viscera in a case of right congenital diaphragmatic hernia

Jeong, Ba‐Da; Ahn, Seo Hee; Song, Jang Ho; Shim, Jae-Yoon; Lee, Mi Young; Won, Hye Sung; Lee, Pil Ryang

doi:10.5468/ogs.2016.59.1.58

Cited by 8 publications

(7 citation statements)

References 15 publications

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“…Intrathoracic kidney anomaly is divided into 4 groups: renal ectopias (a) with a normal diaphragm, (b) with diaphragmatic eventration, (c) with congenital or acquired diaphragmatic hernia, such as Bochdalek hernia, and (d) with traumatic rupture of the diaphragm. 9 In many cases, the intrathoracic kidney can be easily lowered into the abdominal cavity without causing hemodynamic impairment because of its enough vascular length. 1,5 Surgical exploration is not required for asymptomatic intrathoracic kidneys, but it is unavoidable in Bochdalek hernia or post-traumatic diaphragmatic hernias.…”

Section: Discussionmentioning

confidence: 99%

Imaging of Intrathoracic Ectopic Kidney

Dursun¹,

EKER²,

Dursun³

2023

Turkiye Klinikleri J Case Rep

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The ectopic kidney is one of the common congenital anomalies of the urinary system and kidney, and the intrathoracic kidney is one of the rare causes of this anomaly. [1][2][3][4][5] Four basic types of the intrathoracic ectopic kidney have been defined: a closed diaphragm, diaphragm evening, traumatic diaphragmatic rupture, and congenital diaphragmatic hernia. 2,4,6 A case referred to our clinic with a prediagnosis of renal agenesis and diagnosed as the intrathoracic ectopic kidney is discussed in the following. Before the study, the patient's parents were informed and an informed consent form was signed. CASE REPORTA 9-year-old boy applied to the hospital with a complaint of abdominal pain. After abdominal ultrasonography, it was found that his left kidney was absent. The patient was admitted to our hospital's pediatric nephrology outpatient clinic with a pre-diagnosis of left renal agenesis. There were no features in

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Section: Discussionmentioning

confidence: 99%

Imaging of Intrathoracic Ectopic Kidney

Dursun¹,

EKER²,

Dursun³

2023

Turkiye Klinikleri J Case Rep

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“…4 Prenatal diagnosis of CDH is well known; however, ITK is a rare content with only a few cases reported as listed in Table 1. 2,[5][6][7][8][9][10] Embryologically, the kidneys ascend from the pelvis at 5 weeks and reach their adult location in the renal fossa by 8-weeks' gestation.…”

Section: Discussionmentioning

confidence: 99%

“…ITK with CDH constitutes less than 0.25% of ITK cases 4 . Prenatal diagnosis of CDH is well known; however, ITK is a rare content with only a few cases reported as listed in Table 1 2,5‐10 …”

Section: Discussionmentioning

confidence: 99%

A missing kidney and a hidden congenital diaphragmatic hernia

Singh

Shahnaz

Handa

et al. 2020

J of Clinical Ultrasound

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Congenital intrathoracic kidney (ITK) is a rare condition, which is usually discovered incidentally in asymptomatic children who do not need any intervention. However, it may be associated with congenital diaphragmatic hernia (CDH), in which case it requires urgent surgical intervention. We present a case of prenatally diagnosed ITK associated with a left CDH that was operated on day 5 of life. The neonate is currently well at 15 months of age.

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“…Intrathoracic kidney also is a rare variation and is sometimes seen in diaphragmatic hernia [5,6]. Right-sided hernia is more frequently complicated with this situation than left-sided hernia.…”

Section: Discussionmentioning

confidence: 99%

“…Right-sided hernia is more frequently complicated with this situation than left-sided hernia. This variation is usually asymptomatic and, when encountered during repair of the diaphragmatic hernia, the reduction of the kidney to the abdominal space is not difficult and usually causes little problem [5,6].…”

Section: Discussionmentioning

confidence: 99%

Prenatally diagnosed, right-sided congenital diaphragmatic hernia complicated by hepatic pulmonary fusion and intrathoracic kidney

Takezoe¹,

Nomura²,

Ogawa³

et al. 2017

Birth Defect

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Right-sided, congenital diaphragmatic hernia is not common but accounts for about 20% of all congenital diaphragmatic hernia. It sometimes has serious complications, such as intrathoracic kidney and hepatic pulmonary fusion.Here we report a rare case of right-sided diaphragmatic hernia, complicated by intrathoracic kidney and hepatic pulmonary fusion. Repair of the diaphragm via the abdominal approach was difficult and the disease recurred. The second operation was through a right thoracotomy and was successful. The biopsied specimen of the diaphragm contained hepatocytes and bile duct cells which strongly suggested the close relationship between liver and the diaphragm in this case.Right-sided, congenital diaphragmatic hernia (R-CDH) is rare compared to left-sided CDH and accounts for about 20% of the disease. R-CDH is sometimes difficult to diagnose prenatally and Duess et al. reported that prenatal diagnosis and patch closure may be risk factors for increased mortality.Furthermore, R-CDH may be complicated by some specific pathophysiological states, such as intrathoracic kidney and hepatic pulmonary fusion, which is rare but causes complicated and difficult problems for the surgical repair of the diaphragm.In this report, we describe a rare case with the combination of intrathoracic kidney and hepatic pulmonary fusion in R-CDH and discuss the etiology of the disease and surgical treatment.Correspondence to: Yutaka Kanamori, Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Jap2-10-1 Okura, Setagaya, Tokyo 157-8535, Japan, Tel; +81-3-3416-0181, Fax; +81-3-3416-2222; E-mail: kanamori-y@ncchd.go.jp. Case reportThe patient's mother was referred to our institute at 33 weeks of gestation because her baby was suspected to have a right congenital diaphragmatic hernia. Fetal ultrasonography and fetal MRI ( Figure 1a, b) were taken; R-CDH was confirmed with right intrathoracic kidney and careful follow-up was initiated. At 38 weeks and 4 days of gestational age the female patient was born at 2,780 g birth weight and intensive care was started by the neonatologists in the neonatal care unit. A plain chest X-ray showed that the right thoracic space was occupied by the right lobe of the liver and the right lung was severely compressed (Figure 1c). Ultrasound examination revealed that the right lobe of the liver was prolapsed into the right thoracic space, the hepatic veins were draining directly into the right atrium and the inferior vena cave was defective at the retro-hepatic part. The first operation was performed at 1 day old, using an abdominal approach with a right upper transverse incision. The ventral rim of the diaphragm was formed by muscle but the postero-lateral rim was composed of a very thin membrane. This part of the membrane was biopsied, the right lobe of the liver was maneuvered into the abdominal cavity and the membranous diaphragm was taken in by non-absorbable sutures. The severe pulmonary hypertension gradually subsided but art...

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Impaction of an intrathoracic kidney acted as a shield against herniation of the abdominal viscera in a case of right congenital diaphragmatic hernia

Cited by 8 publications

References 15 publications

Imaging of Intrathoracic Ectopic Kidney

Imaging of Intrathoracic Ectopic Kidney

A missing kidney and a hidden congenital diaphragmatic hernia

Prenatally diagnosed, right-sided congenital diaphragmatic hernia complicated by hepatic pulmonary fusion and intrathoracic kidney

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