Fortuitous Discovery of a Bochdalek Hernia in an Adult

Bochdalek hernia is the most common type of congenital diaphragmatic hernia. It is due to a defect in the posterior attachment of the diaphragm muscle, subsequent to a failure of pleuroperitoneal membrane closure in utero. Bochdalek hernia is often asymptomatic in adults, hence, it is fortuitously discovered as an incidental finding on CT scan. Alternatively, it may be diagnosed only after complications occur, such as empyema, cardiac tamponade and gastrointestinal strangulation. CT usually demonstrates a fatty mass above the diaphragm (Figure 1: arrow), which may be associated with other organs entrapment. Coronal and sagittal reformatted images show the diaphragmatic defect (Figure 2: arrows).