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NBME 20 Answers

nbme20/Block 2/Question#11

A female newborn delivered at 36 weeks' gestation ...

Incomplete formation of pleuroperitoneal membrane

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submitted by monoloco(75),

This is a hypoplasia of the pleuroperitoneal membrane. The guts herniate into the thorax, usually on the left side, and result in hypoplasia of the lungs (because they're horribly compressed).

johnthurtjr  Usually on the left because the liver prevents herniation through the right hemidiaphragm +2  
asdfghjkl  aka congenital diaphragmatic hernia +1  
pg32  What's weird to me is that if you usually see air in the intestines on x-ray when they are in the abdomen, why is there no air in the thorax in CDH? The intestines should still have air in them, right? Also, what is filling the abdomen that causes it to appear grayed-out in CDH? +