Congenital right diaphragmatic hernia. A case report and review of the literature.

Congenital right diaphragmatic hernia can present a difficult diagnostic problem. An illustrative case is reviewed in which the diagnosis was not considered during the initial hospitalization because chest radiographs were interpreted as showing an atelectatic and pneumonic process. Once suspected, the diagnosis was made by fluoroscopy, which showed an immobile right hemidiaphragm, and by liver scan, which demonstrated herniation of the liver into the right thorax. The tendency of congenital right diaphragmatic hernias to present after the neonatal period and to mimic pulmonary parenchymal disease is discussed. Several alternative means of diagnosis of right diaphragmatic hernias are reviewed.