Obstructed Bochdalek hernia: a rare presentation of congenital diaphragmatic hernia in adulthood

Authors

  • Vikranth Suresh N. Department of Surgery, Sri Devaraj Urs Medical College, Kolar, Karnataka
  • Sreeramulu P. N. Department of Surgery, Sri Devaraj Urs Medical College, Kolar, Karnataka
  • Shivaprasad Gangadhar Savagave Department of Radiology, Sri Devaraj Urs Medical College, Kolar, Karnataka
  • Sundeep Vogu Department of Surgery, Sri Devaraj Urs Medical College, Kolar, Karnataka

DOI:

https://doi.org/10.18203/2349-2902.isj20193007

Keywords:

Bochdalek hernia, Congenital diaphragmatic hernia, Adult

Abstract

Congenital diaphragmatic hernia (CDH) is usually diagnosed antenatally or during the initial few hours of life in newborns who present with respiratory distress. CDH presenting with intestinal obstruction in adulthood is very rare. We report a case of 28 year old male, who presented to emergency department, with acute onset of abdominal pain and breathlessness since 2 days. Patient was investigated and diagnosed to have Bochdalek hernia (BH), with herniation of intra-abdominal contents to thorax through the defect (3.5×4.5 cms) in postero-lateral aspect of left hemi-diaphragm with obstructive features of bowel. Patient underwent emergency exploratory laparotomy with reduction of contents and hernia repair. Patient recovered and remains well. High suspicion of BH should be done when patient presents with abdominal and respiratory symptoms even though it is very rare in adults.

Author Biographies

Vikranth Suresh N., Department of Surgery, Sri Devaraj Urs Medical College, Kolar, Karnataka

ASSISTANT PROFESSOR
DEPARTMENT OF SURGERY

Sreeramulu P. N., Department of Surgery, Sri Devaraj Urs Medical College, Kolar, Karnataka

PRINCIPAL AND PROFESSOR

DEPT OF GENERAL SURGERY

Shivaprasad Gangadhar Savagave, Department of Radiology, Sri Devaraj Urs Medical College, Kolar, Karnataka

ASSISTANT PROFESSOR

DEPARTMENT OF RADIOLOGY

Sundeep Vogu, Department of Surgery, Sri Devaraj Urs Medical College, Kolar, Karnataka

SURGERY ,RESIDENT

References

Topor L, Pătrăncuş T, Caragaţa R, Moga A. Left congenital diaphragmatic hernia – Case report. Chir (Bucur). 2015;110(1):84–7.

Sutedja B, Muliani Y. Laparoscopic repair of a Bochdalek hernia in an adult woman. Asian J Endosc Surg. 2015;8(3):354–6.

Salústio R, Nabais C, Paredes B, Sousa FV, Porto E, Fradique C. Association of intestinal malrotation and Bochdalek hernia in an adult: a case report. BMC Res Notes. 2014;7:296.

Chatterjee S, Mitra A, Sarkar S, Prasad S. Acute intestinal obstruction: a rare presentation of left sided adult congenital diaphragmatic hernia. Hellenic J Surg. 2015;87(5):427–9.

Herling A, Makhdom F, Al-Shehri A, Mulder DS. Bochdalek hernia in a symptomatic adult. Ann. Thorac Surg. 2014;98(2):701–4.

Brown SR, Horton JD, Trivette E, Hofmann LJ, Johnson JM. Bochdalek hernia in the adult: demographics, presentation, and surgical management. Hernia. 2011;15(1):23–30.

Zhou Y, Du H, Che G. Giant congenital diaphragmatic hernia in an adult. J Cardiothorac Surg. 2014;9:31

Patle NM, Tantia O, Prasad P, Das PC, Khanna S. The management of Bochdalek hernia includes reduction of hernial contents to the peritoneal cavity and repair of the diaphragmatic defect. Indian J. Surg. 2013;75(Suppl 1):303–4.

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Published

2019-06-29

Issue

Section

Case Reports