Congenital diaphragmatic hernia through the oesophageal hiatus with nonrotation of the midgut. A case report.

Observations were made on the cadaver of an 86-year-old subject that presented with a congenital diaphragmatic hernia and nonrotation of the midgut. A hernial sac originating from the peritoneum near the oesophagogastric junction contained the midgut which had herniated through the oesophageal hiatus. An abnormally placed duodenum together with a variation in the drainage of the common hepatic duct were found. These findings are reviewed in relation to the development of the diaphragm and it is suggested that inadequate muscle differentiation in the primative mesenchyme contributes both to the occurrence of congenital oesophageal hiatus hernia and nonrotation of the midgut.