Bochdalek diaphragmatic hernia masquerading as pneumonia - a rare cause of Non-Traumatic Hemothorax

• Published in: The American journal of emergency medicine Vol. 27; no. 2; pp. 252.e1 - 252.e2
• Main Authors: Chiu, Chun-Cheng, MD, Yeh, Hsiu-Fen, MD, Chiu, Te-Fa, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2009; Elsevier Limited
• Subjects: Abdomen; Child, Preschool; Diagnosis, Differential; Emergency; Emergency medical care; Female; Hemothorax - diagnosis; Hemothorax - diagnostic imaging; Hemothorax - etiology; Hemothorax - surgery; Hernia, Diaphragmatic - complications; Hernia, Diaphragmatic - diagnosis; Hernia, Diaphragmatic - surgery; Hernias; Humans; Medical diagnosis; Medical treatment; Radiography
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2008.06.025

Abstract Hemothorax is defined as collection of blood in the pleural cavity. Massive hemothorax may result in severe respiratory distress. We present an extremely rare cause of non-traumatic hemothorax in a 3 1/2-year-old girl by Bochdalek diaphragmatic hernia (BDH), and that was initially misdiagnosed as pneumonia with massive pleural effusion. Hemothorax masks the clinical and X-ray findings of BDH that makes the diagnosis even more difficult. Delayed or incorrect diagnosis of BDH complicated with respiratory distress leads to the wrong decision-making and the subsequent management, which may result in significant morbidity and mortality. Accordingly, emergency physicians need to be aware of this extremely rare etiology when evaluating pediatric hemothorax in a busy emergency department.