Title: Management of Incidental Bochdalek Hernia in An Asymptomatic Adult: A Case Report
Authors: Bhushan D Thombare, Priya Eshpuniyani, Sumanta Das
DOI: https://dx.doi.org/10.18535/jmscr/v4i10.83
Abstract
Bochdalek hernia is a type of Congenital Diaphragmatic Hernia (CDH) that typically presents in childhood. It rarely occurs in adults and most of them are asymptomatic. In this article, we report a case of a 30-year-old male with left-sided Bochdalek hernia who was incidentally diagnosed on chest radiograph. His chest radiograph showed features suggestive of left-sided diaphragmatic hernia, which was confirmed using contrast enhanced Computed Tomography (CECT) of chest and abdomen. The patient underwent left thoracotomy, wherein an 8x10 cm postero-lateral diaphragmatic defect with herniation of the small bowel, spleen, part of stomach, and colon with no peritoneal sac through the opening was found. The contents were reduced into the peritoneal cavity, although a part of omentum had to be sacrificed due to loss of domain and to achieve a tension free repair. The diaphragmatic defect was closed with Dacron patch and sutured to diaphragm with non-absorbable sutures.
Keywords- Bochdalek hernia, Congenital diaphragmatic hernia, Loss of domain (LOD) hernia, Dacron patch, Tension free repair.
References
1. Vega MT, Maldonado RH, Vega GT, Vega AT, Liévano EA, Velázquez PM. Late-onset congenital diaphragmatic hernia: A case report. International Journal of Surgery Case Reports. 2013;4(11):952-954. doi: 10.1016/j.ijscr.2013.07.034.
2. Puri P, Wester T. Historical aspects of congenital diaphramatic hernia. Pediatr Surg Int. 1997; 12: 95– 100. doi:10.1007/BF01349971
3. Machado NO. Laparoscopic Repair of Bochdalek Diaphragmatic Hernia in Adults. North American Journal of Medical Sciences. 2016;8(2):65-74. doi:10.4103/1947-2714.177292.
4. Suzuki T, Okamoto T, Hanyu K, Suwa K, Ashizuka S, Yanaga K. Repair of Bochdalek hernia in an adult complicated by abdominal compartment syndrome, gastropleural fistula and pleural empyema: Report of a case. International Journal of Surgery Case Reports. 2014;5(2):82-85. doi:10.1016/j.ijscr.2013.12.018.