Sonography Unit, *Pediatric Surgery Unit and **Therapy Unit, “Carlos Arvelo” Military Hospital.  Caracas-Venezuela

A 29-year-old patient G3P2 at 30 weeks, was referred for ultrasound polyhydramnios and suspected congenital diaphragmatic hernia.  The study showed: a cystic mass on the left chest , cardiac  displacement  and normal echocardiography:

The abdomen showed a normal hepatic vasculature:

and a horseshoe kidney:

Single umbilical artery:

There was also polyhydramnios.

The baby was delivered 37 weeks for uterine contractions by cesarean section. An EXIT procedure was performed with delivery of a 3400g female newborn.

The postnatal radiography confirms the left-sided diaphragmatic hernia.

The newborn was transferred to surgery:

At surgery a small left diaphragmatic defect was found. The stomach, intestinal loops and spleen had herniated into the left chest (Bochdalek Hernia); the left lung was hypoplastic and left renal fossa empty.
The newborn died of postoperative complications 72 hours latter.  The pathology confirmed the hypoplastic left lung and the horseshoe kidney: