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The posterolateral (Bochdalek) diaphragmatic hernia was repaired successfully. This case report highlights the importance of including a late-presenting CDH in the differential diagnoses of pediatric patients who present with respiratory distress, chest pain, non-bilious vomiting, and radiological findings suggestive of tension pneumothorax.Background Pilonidal sinus (PS) disease frequently occurs in adolescents and young adults, and in many cases involves wide excision or local flaps as treatment. These treatments are associated with a