2009•Formosan Journal of SurgeryRequires access

Adult Bochdalek Hernia: Report of a Case

Chu-Chun Huang, C. P. Hsu, Jane-Yi Hsu

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Abstract

Bochdalek hernia is the most common type of congenital diaphragmatic hernia that occurs predominantly in children, but rarely in adults.1 The Bochdalek hernia occurs when the abdominal contents herniate into the chest cavity through the posterolateral portion of the diaphragm. We present a case of a 27-year-old male who presented with fever and cough. Physical examination disclosed coarse breathing sounds in the left lower lung field. The chest X-rays showed left-side pleural effusion, and computed tomography (CT) of the chest revealed massive herniation of the omentum and partial herniation of the colon into the left pleural cavity through the posterolateral portion of the left hemidiaphragm. The initial approach was a limited thoracotomy for the diaphragmatic hernia. Because of difficulties in complete repair of the diaphragmatic defect, thoracoscopy was used to assist the procedure. The patient had an uneventful postoperative course.

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What this paper is about

Bochdalek hernia is the most common type of congenital diaphragmatic hernia that occurs predominantly in children, but rarely in adults.1 The Bochdalek hernia occurs when the abdominal contents herniate into the chest cavity through the posterolateral portion of the diaphragm. We present a case of a 27-year-old male who presented with fever and cough. Physical examination disclosed coarse breathing sounds in the left lower lung field. The chest X-rays showed left-side pleural effusion, and computed tomography (CT) of the chest revealed massive herniation of the omentum and partial herniation of the colon into the left pleural cavity through the posterolateral portion of the left hemidiaphragm. The initial approach was a limited thoracotomy for the diaphragmatic hernia. Because of difficulties in complete repair of the diaphragmatic defect, thoracoscopy was used to assist the procedure. The patient had an uneventful postoperative course.

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Available abstract

Bochdalek hernia is the most common type of congenital diaphragmatic hernia that occurs predominantly in children, but rarely in adults.1 The Bochdalek hernia occurs when the abdominal contents herniate into the chest cavity through the posterolateral portion of the diaphragm. We present a case of a 27-year-old male who presented with fever and cough. Physical examination disclosed coarse breathing sounds in the left lower lung field. The chest X-rays showed left-side pleural effusion, and computed tomography (CT) of the chest revealed massive herniation of the omentum and partial herniation of the colon into the left pleural cavity through the posterolateral portion of the left hemidiaphragm. The initial approach was a limited thoracotomy for the diaphragmatic hernia. Because of difficulties in complete repair of the diaphragmatic defect, thoracoscopy was used to assist the procedure. The patient had an uneventful postoperative course.

Key concepts: Bochdalek hernia, Medicine, Thoracotomy, Thoracic cavity, Thoracoscopy, Surgery, Diaphragm (acoustics), Hernia

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