Imaging

Foramen of Bochdalek hernia

Preliminary Diagnosis: Foramen of Bochdalek Hernia

I. What imaging technique is first-line for this diagnosis?

Chest X-ray, PA, and lateral view.

II. Describe the advantages and disadvantages of this technique for diagnosing foramen of bochdalek hernia?

Advantages

  • Relatively inexpensive and highly portable imaging modality.

  • Exposes patients to minimal ionizing radiation.

  • Plain radiography is highly sensitive for diagnosing a foramen of bochdalek hernia.

Disadvantages

  • Plain radiography is not very specific for diagnosing a foramen of bochdalek hernia.

III. What are the contraindications for the first-line imaging technique?

No specific contraindications to plain radiography exist. Consent may be required at some institutions for pregnant patients.

IV. What alternative imaging techniques are available?

CT imaging of the chest, abdomen, and/or pelvis with and/or without PO and IV contrast.

V. Describe the advantages and disadvantages of the alternative techniques for diagnosing foramen of bochdalek hernia.

Advantages

  • CT imaging is the gold standard in diagnosing foramen of bochdalek hernia.

  • CT imaging helps guide treatment.

  • More sensitive and specific in diagnosing a foramen of bochdalek hernia, and in detailing and characterizing any secondary complications than plain radiography.

Disadvantages

  • Exposes patients to ionizing radiation.

  • Far less portable and more expensive compared to companion plain radiography.

VI. What are the contraindications for the alternative imaging techniques?

May be contraindicated in pregnant patients.

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