Strangulated Bochdalek hernia: Approach of management in emergency setting
Document Type
Article
Publication Date
1-1-2021
Abstract
Bochdalek hernia is a type of congenital diaphragmatic hernia that primarily manifests in children however in rare instances they do manifest in adulthood spontaneously or after physical exertion. We report a case of a left-sided Bochdalek hernia in an adult who presented with left-sided chest pain and worsening symptoms of dyspnea. His chest radiograph revealed dilated small bowel loops in the left hemithorax causing a mediastinal shift. A computed tomography done revealed a posterolateral diaphragmatic defect through which the abdominal viscera had herniated. He was subsequently intubated due to severe respiratory distress. The patient underwent an emergency laparotomy which revealed a large 10 cm posterolateral diaphragmatic defect with herniation of small bowel, spleen and transverse colon. The small bowel was gangrenous and perforated therefore a primary repair of the defect with nonabsorbable sutures was done. Gangrenous bowel was resected and primary anastomosis was done. Postoperatively, the patient had significant clinical improvement and was discharged a week later with no immediate complications.
Keywords
Agenesis of hemidiaphragm, Bochdalek hernias, Congenital diaphragmatic defect, Congenital diaphragmatic hernias, Spiral computed tomography
Divisions
surgerydept
Publication Title
Gazi Medical Journal
Volume
32
Issue
3
Publisher
Gazi University