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Eur J Cardiothorac Surg 2003;23:421
© 2003 Elsevier Science NL

Images in cardio-thoracic surgery

An unusual case of breathlessness

G.P. Curriea*, T. Taylorb, W.S. Walkerc, R.P. Smitha

a Respiratory Department, East Block, Level 4, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
b Radiology Department, Ninewells Hospital & Medical School, Dundee DD1 9SY, UK
c Thoracic Surgery Unit, Royal Infirmary of Edinburgh, Lauriston Place, Edinburgh EH3 9YW, UK

Received 29 November 2002; accepted 9 December 2002.

* Corresponding author. Tel.: +44-1382-496440; fax: +44-1382-644972
e-mail: g.p.currie{at}dundee.ac.uk

Key Words: Hernia • Bowel • Left hemithorax

Chest imaging was obtained from a breathless 42-year-old woman. Elective surgery revealed a large hernia at the foramen of Bochdalek with almost all the bowel lying in the left hemithorax. Congenital diaphragmatic defects usually present in the neonatal period with respiratory distress; uncommonly they may present in an adult (Figs. 1 and 2 ).



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  		Fig. 1. Chest X-ray showing left sided opacification with sparing of the apex.

 


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  		Fig. 2. Barium meal and follow through showing bowel in the left hemithorax.

 




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