A 77-year-old presented to the emergency department with complaints of nausea, vomiting and diarrhoea. He had no known previous illnesses and reported of no cough or shortness of breath.
Physical examination revealed decreased breath sounds in the lower third of the right side of the chest. Chest x-ray revealed an opacity in the right hemithorax. A computed tomography was performed of the check which showed a right Bochdalek hernia containing the hepatic flexure of the colon and kidney.
The imaging was consistent with the diagnosis of an ectopic kidney defect because of a right Bochdalek hernia. An ectopic kidney is a birth defect in which the kidney is located in an abnormal position. In most cases, there are no presenting symptoms, whereas, in some cases an ectopic kidney may create urinary problems, for example, urinary stones, infection and urinary blockage.
Bochdalek hernia
A Bochdalek hernia is a congenital anomaly with a posteriolateral diaphragmatic defect. An opening exists in the infant’s diaphragm which allow the stomach and intestines to protrude into the thoracic cavity. These are organs which are normally intra-abdominal. It is a common incidental finding. The hernia is small and often contains only fat.
However, it is less common for the hernias to contain the kidney, as the case with this patient. The patient’s gastrointestinal symptoms were treated with supportive care, whereas, no specific treatment was initiated for the hernia.
No specific treatment was initiated for the hernia, and the patient’s gastrointestinal symptoms abated with supportive care.
References
Almeida, C. C., & Vaz, A. M. (2020). Ectopic Kidney. New England Journal of Medicine, 383(5), e30.
