Ureteral diaphragmatic hernia through the right Bochdalek foramen complicated with left hiatal hernia in an adult: A case report with literature review

Bochdalek foramen ureteral diaphragmatic hernia is rare, and concurrent hiatal hernia is unreported. We retrospectively analyzed a 79-year-old female with right lumbago-abdominal pain, diagnosed via CTU with right Bochdalek ureteral hernia-induced severe hydronephrosis and incidental left hiatal hernia. Transurethral ureteral stenting with flexible ureteroscopy relieved symptoms immediately and normalized renal function. Hierarchical care refers to a tiered medical system where patients are initially evaluated at primary hospitals and referred to higher-level centers for complex diagnosis and treatment. This case highlights distinguishing pathogenic from concurrent hernias and the value of hierarchical care.