Pleuroperitoneal Diaphragmatic Hernia (Bochdalek´s Hernia) vs. Sternocostal Diaphragmatic Hernia (Foramen Morgagni Hernia)
Left picture at the top: The diagnosis is a small congenital diaphragmatic hernia of the left side with displacement of a tip of an intestinal loop in the thoracic cavity. The defect lies at the back and laterally = Bochdalek´s diaphragamtic hernia(third picture from the top). In the foreground in the first picture from the top a part of the left hepatic lobe is visible. Right picture: The diagnosis is bilateral sternocostal diaphragmatic hernia (foramen of Morgagni hernia), in which the larger defect lies anteriorly on the right paramedian side with a bipartite part of the liver, and the smaller defect on the left side with a small plug of hepatic tissue.
Left picture: Operative findings in a toddler (first picture from the top); he had symptoms and signs of an obstructive ileus and a blurred limited dome of the diaphragm on x-ray (second picture from the bottom). In the first picture from the top view of the left dome of the diaphragm: The hand of the surgeon is pulling an intestinal loop which tapers to a point in the direction of the diaphragm (on the left side in the picture). Right picture: Operative findings in an infant with an incidental finding of a bilateral semicircular opacity above the diaphragmatic contours on chest x-ray (picture at the bottom of another patient with such an opacity on the right side). Following a bilateral subcostal incision a rose-colored zone is visible, corresponding to the diaphragm following removal of the hernia sac (top and left in the picture); in the middle of the field of view a bipartite parenchymatous organ can be seen.