Hernia

, Volume 9, Issue 3, pp 284–287 | Cite as

Bochdalek’s hernia in an adult with colon necrosis

Case Report

Abstract

The improper fusion of the posterolateral foramina of the diaphragm was first described by Bochdalek in 1848. The true incidence of this congenital anomaly ranges from 1/7,000 to 6%. Although it is a well-known neonatal disease, it can also be diagnosed incidentally in adult patients. Until now, a total of around 100 cases of occult asymptomatic Bochdalek’s hernia have been reported. The symptomatic cases are encountered more rarely. Colon necrosis among the symptomatic cases was reported in some cases. We herein report a case of a 21-year-old man with a left-sided Bochdalek’s hernia which led to total necrosis of the transverse colon. Following resection and colocolonic anastomosis, the defect on the diaphragm was repaired. After an uneventful recovery period, he was discharged from the hospital on the 10th postoperative day. Being aware of this rarely encountered disease and of the factors for early diagnosis is of utmost importance to decrease mortality and morbidity.

Keywords

Bochdalek’s hernia Strangulation Symptoms 

References

  1. 1.
    Fine R, Borrero E, Stone A (1987) Bochdalek hernia in adulthood. N Y State J Med 87:516–518PubMedGoogle Scholar
  2. 2.
    Salacin S, Alper B, Cekin N, Gulmen MK (1994) Bochdalek hernia in adulthood: a review and autopsy case report. J Forensic Sc 39:1112–1116Google Scholar
  3. 3.
    Haller SA (1986) Professor Bochdalek and his hernia: then and now. Prog Paediatr Surg 20:252–255Google Scholar
  4. 4.
    Guzzetta PC, Anderson KD, Altman RP, Newman KD, Schnitzer JJ (1999) Pediatric surgery. In: Schwartz SI, Shires GT, Spencer FC, Daly JM, Fischer JE, Galloway AC (eds) Principles of surgery. McGraw-Hill Companies, New York, pp 1715–1754Google Scholar
  5. 5.
    Hines GL, Romero C (1983) Congenital diaphragmatic hernia in the adult. Int Surg 68:349–351PubMedGoogle Scholar
  6. 6.
    Mullins ME, Stein J, Saini SS, Mueller PR (2001) Prevalence of incidental Bochdalek’s hernia in a large adult population. AJR Am J Roentgenol 177:363–366PubMedGoogle Scholar
  7. 7.
    Losanoff JE, Sauter ER (2004) Congenital posterolateral diaphragmatic hernia in an adult. Hernia 8:83–85CrossRefPubMedGoogle Scholar
  8. 8.
    Betremieux P, Dabadie A, Chapuis M, Pladys P, Treguier C, Fremond B, Lefrancois C (1995) Late presenting Bochdalek hernia containing colon: misdiagnosis risk. Eur J Pediatr Surg 5:113–115PubMedCrossRefGoogle Scholar
  9. 9.
    Nitecki S, Bar-Maor JA (1992) Late presentation of Bochdalek hernia: our experience and review of the literature. Isr J Med Sc 28:712–714Google Scholar
  10. 10.
    Gale ME (1985) Bochdalek hernia: prevalence and CT characteristics. Radiology 156:449–452PubMedGoogle Scholar
  11. 11.
    Houben JJ, De Laet MH, Godart S, Bouckaert J, Govaerts M, Bouton JM, Collier F, Dereere R, Derom F, Vansande S (1984) Bochdalek’s congenital diaphragmatic hernia: a clinical review of 114 cases. Acta Chir Belg 84:7–12PubMedGoogle Scholar
  12. 12.
    Schumpelick V, Steinau G, Schluper I, Prescher A (2000) Surgical embryology and anatomy of the diaphragm with surgical application. Surg Clin North Am 80:213–239CrossRefPubMedGoogle Scholar
  13. 13.
    Detti L, Mari G, Ferguson JE (2001) Color Doppler ultrasonography of the superior mesenteric artery for prenatal ultrasonographic diagnosis of a left-sided congenital diaphragmatic hernia. J Ultrasound Med 20:689–692PubMedGoogle Scholar
  14. 14.
    Wells LJ (1954) Development of the human diaphragm and pleural sacs. Contrib Embryol 35:107–134Google Scholar
  15. 15.
    Kanazawa A, Yoshioka Y, Inoi O, Murase J, Kinoshita H (2002) Acute respiratory failure caused by an incarcerated right-sided adult Bochdalek hernia: report of a case. Surg Today 32:812–815CrossRefPubMedGoogle Scholar
  16. 16.
    Chui PP, Tan CT (1993) Sudden death due to incarcerated Bochdalek hernia in an adult. Ann Acad Med 22:57–60Google Scholar
  17. 17.
    Osebold WR, Soper RT (1976) Congenital posterolateral diaphragmatic hernia past infancy. Am J Surg 131:748–754CrossRefPubMedGoogle Scholar
  18. 18.
    Haines JO, Collins RB (1970) Bochdalek hernia in an adult simulating a pleural effusion. Radiology 95:277–278PubMedGoogle Scholar
  19. 19.
    Shimizu T, Hira S, Hirooka S, Yonekura T, Tamai H (2002) Late onset of right Bochdalek’s hernia with strangulation of the omentum. Acta Pediatr 91:483–485CrossRefGoogle Scholar
  20. 20.
    Gayer G, Bilik R, Vardi A. (1999) CT diagnosis of delayed presentation of congenital diaphragmatic hernia simulating massive pleuropneumonia. Eur Radiol 9:1672–1674CrossRefPubMedGoogle Scholar
  21. 21.
    Schutter FW, Kiroff P, Leister I (1995) Ileus of the large intestine as a late sequela of direct diaphragmatic rupture. Zentralbl Chir 120:977–980PubMedGoogle Scholar
  22. 22.
    de Oliveira F, Oliveira FJ (1984) Congenital posterolateral diaphragmatic hernia in the adult. Can J Surg 27:610–611PubMedGoogle Scholar
  23. 23.
    Fingerhut A, Pourcher J, Pelletier JM, Berteaux D, Bourdain JL, Nouailhat F (1978) Two cases of postero-lateral diaphragmatic hernia(congenital Bochdalek hernia) revealed at adult age by severe complications. Operation and cure. Review of the literature. J Chir (Paris) 115:135–143Google Scholar
  24. 24.
    Kuhn R, Schubert D, Marush F, Lippert H, Pross M (2002) Repair of diaphragmatic rupture by laparoscopic implantation of a polytetrafluoroethylene patch. Surg Endosc 16:1495CrossRefPubMedGoogle Scholar
  25. 25.
    Lima M, Lauro V, Domini M, Libri M, Bertozzi M, Pigna A, Domini R (2001) Laparoscopic surgery of diaphragmatic diseases in children: our experience with five cases. Eur J Pediatr Surg 11:377–381CrossRefPubMedGoogle Scholar
  26. 26.
    Brusciano L, Izzo G, Maffettone V, Rossetti G, Renzi A, Napolitano V, Russo G, Del Genio A (2003) Laparoscopic treatment of Bochdalek hernia without the use of a mesh. Surg Endosc 17:1497–1498PubMedGoogle Scholar
  27. 27.
    Willemse P, Schutte PR, Plaisier PW (2003) Thoracoscopic repair of a Bochdalek hernia in an adult. Surg Endosc 17:162PubMedGoogle Scholar
  28. 28.
    Arca MJ, Barnhart DC, Lelli JL Jr, Greenfeld J, Harmon CM, Hirschl RB, Teitelbaum DH (2003) Early experience with minimally invasive repair of congenital diaphragmatic hernias: results and lessons learned. J Pediatr Surg 38:1563–1568CrossRefPubMedGoogle Scholar
  29. 29.
    Tsang TM, Tam PK, Dudley NE, Stevens J (1995) Diaphragmatic agenesis as a distinct clinical entity. J Pediatr Surg 30:16–18CrossRefPubMedGoogle Scholar
  30. 30.
    Kirkland JA (1959) Congenital posterolateral diaphragmatic hernia in the adult. Br J Surg 47:16–22PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • A. Kocakusak
    • 1
  • S. Arikan
    • 1
  • O. Senturk
    • 1
  • A. F. Yucel
    • 1
  1. 1.Haseki Education and Research Hospital General Surgery ClinicIstanbulTurkey

Personalised recommendations