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Congenital diaphragmatic hernia — MRCPCH TAS MCQ

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HardEmbryologyCongenital diaphragmatic herniaMRCPCH TAS

A newborn has severe respiratory distress, scaphoid abdomen and bowel sounds in the chest. Imaging shows abdominal contents in the left hemithorax with mediastinal shift. What is the most likely embryological defect?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Failure of pleuroperitoneal membrane closure

Bochdalek congenital diaphragmatic hernia results from failure of pleuroperitoneal membrane closure, allowing abdominal contents into the thorax. Failure of midgut return explains omphalocele, not intrathoracic bowel. The key clinical consequence is pulmonary hypoplasia from thoracic compression before birth.

Reference: Gray's Anatomy; Nelson Textbook of Pediatrics; RCPCH Theory examination syllabi