Anteromedial hernias occur as a result of the defects of the diaphragma at parasternal or retrosternal field. Most of the anterior hernias are asymptomatic and the diagnosis is made by chest radiographs incidentally. This case is present for the rare association of Down syndrome with anterior and especially anteriomedial hernias.

A seventeen-month old girl who had stigmas of Down syndrome was referred to our clinic with the complaints of cough, fever and vomiting. On physical examination, pulmonary sounds were loud and occasional crepitan rales were heard. Subcostal and intercostal retractions were present. The bowel sounds were heard at the left hemithorax. Intestinal loops were seen within the thorax cavity at radiographic examination with barium sulphate.

Various additional anomalies can accompany Down syndrome. Here we emphasize that Down syndrome can be in association with congenital diaphragmatic hernias even many of these cases are asymptomatic and these cases must be evaluated in this respect.