Congenital right-sided diaphragmatic hernia; some difficulties in differential diagnosis and operative repair.

Right-sided congenital diaphragmatic hernia has in the past been considered to be incompatible with life. Even as recently as 1925 Hedblom stated that 75 per cent. of all cases of congenital diaphragmatic hernia die before the age of one month. With modem advances in technique death is now in most cases avoidable, and must be blamed on failure to diagnose correctly. Mis-diagnosis is so much the rule that in adult life diaphragmatic hernia has been called 'the masquerader of the upper abdomen,' and it has been calculated that on an average three incorrect diagnoses are made before the correct one is established (Harrington, 1945). In infants and young children, in whom cardio-respiratory symptoms often predominate, the diagnosis is even more likely to be missed. In this paper two cases with right-sided congenital diaphragmatic hernia are described; in neither was the diagnosis established until several other tentative diagnoses had been discarded.