An Unusual Etiology of Chest Pain in a Patient With a History of Left-Sided Congenital Diaphragmatic Hernia

Congenital diaphragmatic hernia (CDH) is a discontinuity of the diaphragm in which abdominal viscera herniates into the chest (Hedrick & Adzick, 2016). A 16-year-old female patient with a past medical history of a left-sided CDH presented with severe pain to her left upper quadrant and chest. An initial diagnosis was made of a recurrent CDH and subsequent herniation of the left kidney into the thoracic space. Intraoperatively, her previous diaphragmatic repair was found to be intact, but a sharp bony protrusion, determined to be an exostosis of the posterior lateral aspect of one of her ribs, was noted. Rongeurs of this lesion resulted in resolution of this patient's symptoms.