Bochdaleck hernia location:
Correct Answer: Posterolateral
Description: Ans. (a) PosterolateralRef.: Bailey & Love 26th ed. / 871-72* Bochdaleks hernia is the most common form of diaphragmatic hernia, occurring in approximately 1 in 2500 births and twice as often in males as in females.* Bochdaleks hernia results from failure of normal development of the posterolateral diaphragm during embryogenesis.* Separation of the developing thoracic and abdominal cavities occurs during the eighth week of gestation, when the opening between the chest and abdomen (the pleuroperitoneal canal) closes. A congenital diaphragmatic hernia results when the pleuroperitoneal membrane fails to form.* Most Bochdaleks hernias occur on the left side, allowing protrusion of the abdominal viscera into the chest. The herniated bowel passes through the defect, filling the chest cavity and causing hypoplasia of the left lung and a shift of mediastinal structures to the right side. It is not uncommon for other abnormalities to be associated with Bochdaleks hernia; these may include neural tube defects and cardiovascular abnormalities* The left-sided Bochdalek hernia occurs in approximately 85% of cases. Left-sided hernias allow herniation of both the small and large bowel and intraabdominal solid organs into the thoracic cavity.* In right-sided hernias (13% of cases), only the liver and a portion of the large bowel tend to herniate. Bilateral hernias are uncommon and are usually fatalRemember* The 3 basic types of congenital diaphragmatic hernia include the posterolateral Bochdalek hernia (occurring at approximately 6 weeks' gestation), the Anterior Morgagni hernia, and the hiatus hernia.
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