CDH POCUS Case

Lung ultrasound at the level of the Right Upper Lobe in a patient with a left-sided congenital diaphragmatic hernia (CDH). One may appreciate the thymus, as well as the pleural line with some "comet tails". One may also appreciate some of the A-lines from the reflection of the pleura. Here the right upper lung is well aerated. 

M-Mode of lung right upper lobe with lung-sliding and the absence of a pneumothorax. Here we can appreciate the "sand on the breach" appearance - absence of a pneumothorax. 

Left chest scan outlining some bowels under the ribs in a left-sided CDH.

Some RV dilatation with mild RV dysfunction (slighlty decreased TAPSE - not presented here).

Overall, LV within normal function. Some dyskinesis of the septum. 

Trivial tricuspid regurgitation.

LVOT with Doppler colour. 

RV-RA of about 51 mmHg - Isosystemic RV systolic pressure. 

A2C with adequate LV function. 

Subcostal view outlining a left to right PFO. 

Subhepatic vein dilated with some retrograde flow.

Here one may appreciate the white delineation of the right diaphragm and the absence of a diaphragm on the left side. 

Right diaphragm present and with motion during breathing pattern. 

Absent diaphragm on the left. 

Presence of the diaphragm on the right side. 

M-mode outlining diaphragmatic motion of the right diaphragm with the breathing.