Isolated intrathoracic kidney

A 75‐year‐old woman presented to her general practitioner with several weeks of dyspnoea. Examination revealed decreased air entry in the right lung base.

After some initial investigations, she underwent computed tomography of the chest, which showed a right‐sided diaphragmatic hernia containing the ipsilateral kidney (Figure, A [coronal view] and B [sagittal view]). Renal function was normal and renal perfusion scanning (^99mTc MAG3) estimated a functional contribution of 62% from the right kidney.

The presence of an intrathoracic kidney is a rare complication of diaphragmatic hernia.1 The follow‐up and management plan needs to be individualised and should consider the patient’s symptoms, the possibility of incarceration of the hernia contents, and the risks of surgical intervention. In this case, it was an incidental imaging finding unrelated to the patient’s presenting symptom. Her dyspnoea resolved without treatment and imaging appearances were stable one year after her initial presentation.