Intrathoracic Kidney Associated with Bochdalek Hernia: A Case Report with Renal and Pulmonary Function Assessment

Abstract

Aims: To describe a rare presentation of intrathoracic renal ectopia associated with a right-sided Bochdalek hernia, incidentally identified during evaluation for acute respiratory symptoms, and to highlight its potential impact when combined with underlying pulmonary disease. Presentation of Case: A 70-year-old male, chronic smoker, was admitted for dyspnea and fever. Thoracic CT (Computed Tomography) revealed right-sided pleuropneumopathy in emphysematous lungs and incidentally identified a right intrathoracic ectopic kidney associated with a homolateral Bochdalek hernia. Renal morphology and function were normal, and the patient reported no abdominal or urinary symptoms. Discussion: Intrathoracic renal ectopia is a rare congenital anomaly, occurring in less than 5% of ectopic kidney cases. It is frequently associated with a Bochdalek hernia due to pleuroperitoneal membrane fusion failure. Typically asymptomatic, it is often discovered incidentally during thoracic imaging. Its intrathoracic position may reduce ipsilateral lung volume, and while renal function usually remains preserved, respiratory function may be further impaired in the presence of underlying lung disease. In this case, the coexistence of emphysema, pneumonia, and reduced thoracic space likely contributed to respiratory compromise. Standard radiography may suggest a thoracic mass, but definitive diagnosis relies on CT, ultrasound, or MRI. Conclusion: Intrathoracic kidney with Bochdalek hernia is usually asymptomatic but may become clinically relevant when associated with pulmonary disease due to reduced respiratory capacity. Awareness of this entity helps prevent misdiagnosis and supports accurate assessment of thoracic symptoms.