Type:
Educational Exhibit
Keywords:
Not applicable, Volvulus, Hernia, Congenital, Complications, CT, Conventional radiography, Trauma, Thorax, Stomach (incl. Oesophagus), Chest
Authors:
A. B. Giurgiu1, F. R. Eniu2, B. AANEI1, D. Munteanu3; 1Cluj-Napoca/RO, 2Cluj/RO, 3Cluj-Napoca, Cluj/RO
DOI:
10.26044/ecr2020/C-03059
Background
Diaphragmatic hernia is defined as a defect in the diaphragm, which allows herniation of the abdominal content into the thorax. Detection of asymptomatic DH is rare among adults, being generally associated with increased intra-abdominal pressure, due to blunt trauma, physical exertion or pregnancy, with hiatal hernia being the commonest type. Rarely, it may occur due to a previously unidentified congenital diaphragmatic defect (Bochdalek and Morgagni hernia) [1].
Chest X-ray is the first line imaging technique used for indentifying any thoracic pathology, being frequently responsible for detecting incidental DH. However, chest radiographs may lead to diagnostic confusion in situations which mimic DH.
Multiple detector computed tomography (MDCT) with multiplanar reformations (MPR) represents the most sensitive imaging modality in detecting occult DH, providing detailed information about the type of hernia, content and diaphragmatic defect, allowing assessment of possible complications [1].
With high sensitivity for soft tissue characterization, magnetic resonance imaging (MRI) is recommended for further classification of non-acute DH, especially those involving cardiac structures [1].