Journal of Ultrasound in Medicine, Vol 5, Issue 7 391-396, Copyright © 1986 by American Institute of Ultrasound in Medicine
The antenatal diagnosis of diaphragmatic anomalies
C. H. Comstock
In an evaluation of eight fetal diaphragmatic anomalies a number of
suggestive antenatal ultrasound findings were identified. The feature most
suggestive of a posterolateral hernia (foramen of Bochdalek) is malposition
of the heart. Peristalsis of chest contents or movement of abdominal
contents into the chest on inspiration are more specific findings. Absence
of an intra-abdominal stomach, a small abdominal circumference, and a
cystic or solid mass in the chest are suggestive but not specific. It may
be difficult or impossible to distinguish a posterolateral diaphragmatic
defect from the much less frequent eventration of the diaphragm. An
anteromedial defect of the diaphragm (foramen of Morgagni) presented as an
intrathoracic anterior solid mass and should be considered in the
differential diagnosis of an anterior chest mass. Although all three types
of defects are frequently associated with additional anomalies, severe
pulmonary hypoplasia is not a complication of eventration or anteromedial
defects.
