Late onset of right Bochdalek's hernia with strangulation of the omentum.
We report a case of bloody pleural effusion and infarction of the greater omentum caused by a non-traumatic diaphragmatic hernia with a late presentation. A 15-y-old boy with Down's syndrome developed abdominal pain and vomiting, as well as an elevated serum level of C-reactive protein. Chest roentgenograms showed a right-sided pleural effusion and computed tomography revealed a right diaphragmatic hernia. Barium enema confirmed the diagnosis. An operation revealed a right Bochdalek's hernia with strangulation of the greater omentum in the right pleural cavity.


CONCLUSIONS
Diaphragmatic hernia should be considered in patients with pleural effusion, abdominal pain and vomiting.
Shimizu
T
T
Department of Pediatrics, Ikoma General Hospital, Ikoma-City, Nara, Japan. shimizut@kcn.ne.jp
Hira
S
S
Hirooka
S
S
Yonekura
T
T
Tamai
H
H
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D017668:Age of Onset; D002097:C-Reactive Protein / Q000032:analysis; D015897:Comorbidity; D004314:Down Syndrome / Q000453:epidemiology; D006548:Hernia, Diaphragmatic / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D006801:Humans; D007238:Infarction / Q000209:etiology*; D008297:Male; D009852:Omentum / Q000098:blood supply*; D010996:Pleural Effusion / Q000209:etiology*; D011859:Radiography
D002097:C-Reactive Protein