Bochdalek hernia presenting in adult life: report of an unusual case and review of the literature

Abstract

SUMMARY
Below, we present the case of a middle-aged woman with a
symptomatic congenital posterior diaphragmatic (Bochdalek)
hernia that remained undiagnosed for years. During the last
attack, when she was referred to our institution, she had a
large thoracic herniation of several abdominal viscera
including the stomach, which was also rotated along its
transverse axis (gastric volvulus). After a chest radiograph
no time was wasted on further investigations and she was
rushed to theatre for exploration through a midline
laparotomy. The hernia was reduced, the viscera returned
to the abdominal cavity and the process of strangulation
arrested. A gastropexy was performed. The patient remains
well on follow-up. It is important to be aware of the existence
of congenital Bochdalek hernias presenting in adult life,
with lethal complications if left untreated. In these
situations prompt surgery is indicated and should be
performed to restore the abdominal anatomy and repair the
hernial defect.
Key words: Diaphragm, Diaphragmatic hernia, Congenital,
Bochdalek hernia, Gastric volvulus, Adult