CDH POCUS Case
Lung POCUS
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.
Similar patterns by M-Mode of the Lung at the right upper and lateral levels (no pneumothorax).
Left chest scan outlining some bowels under the ribs in a left-sided CDH.
Cardiac POCUS
Parasternal short axis view with a dilated RV and some bowing of the septum at peak of systole. Here the bowing of the LV septum could be secondary to increased RV systolic pressure. It could also be secondary to LV hypotension, or a combination of both.
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.
Diaphragmatic motion - Subxyphoid view
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.
