Search

Diaphragmatic hernias that are diagnosed in adulthood may be traumatic or congenital in nature. Therefore, respiratory specialists need to be aware of the presentation of patients with these conditions. In this report, we describe a case series of patients with congenital and traumatic diaphragmatic hernias and highlight a varied range of their presentations. Abnormalities were noted in the thorax on the chest radiographs, but it was unclear as to the nature of the anomaly. The findings on thoracic ultrasound conducted by a pulmonologist helped to direct appropriate investigations avoiding unnecessary interventions. Instead of pleural effusions, consolidation or collapse, thoracic computed tomography demonstrated diaphragmatic hernias which were managed either conservatively or by surgery. There is increasing evidence that pulmonary specialists should be trained in thoracic ultrasonography to identify pleural pathology as well as safely conducting pleural-based interventions.

We present a case of a 66-year-old woman with cough and palpitations who was found to have partial anomalous pulmonary venous return (PAPVR) of the left lung which drained into the left brachiocephalic vein. This is the first case of such an extensive asymptomatic PAPVR presenting in later life. This case demonstrates the importance of cross-sectional imaging in defining the spectrum of PAPVR and other vascular anomalies of the thorax. This case raises the possibility of a PAPVR as the location for a malpositioned central venous catheter tip lying in a left para-vertebral location.