PDF(Pubmed)
Abstract：
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.
摘要：
Bochdalek疝气是the肌的遗传性后外侧缺损，可使腹部器官疝入胸腔。除了是最常见的先天性膈疝（CDH），它也是大多数时间在左半胸部观察到的类型。异位肾是一种罕见的疾病，而异位胸内肾的发生更是少见,仅占所有肾脏异位病例的少数。与Bochdalek疝气相关的胸内肾的发生在成年人中很少见，通常是偶然发现。一名52岁的肥胖女性患者出现在肺科门诊病房，并报告出现咳嗽症状，喘息,三年来呼吸困难.胸部X光片显示右侧隔膜的圆顶升高。胸部计算机断层扫描（CT）显示右半隔膜后部有缺陷，右肾突出，腹膜后脂肪进入右半胸部。CT尿路造影显示胸内肾脏大小正常，增强，造影剂迅速排泄到骨盆系统中。关于疝的小尺寸，并考虑到CT尿路造影没有并发症，建议对患者进行保守治疗。每年对患者进行随访。随访期间无肾脏并发症发生。在评估患有“半膈肌抬高”或“胸部肿块”的患者时，必须检查胸内肾的存在,以避免不良的外科手术和图像引导活检.
