Incidence and MDCT characteristics of asymptomatic Bochdalek's hernia in adult population

Temízöz, Osman; Gençhellaç, Hakan; Yekeler, Ensar; Umit, Hasan; Ünlü, Ercüment; Özdemir, Hüseyin Baran; Demir, Mustafa Kemal

doi:10.4261/1305-3825.dir.2750-09.1

Cited by 32 publications

(44 citation statements)

References 17 publications

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“…The size of a BH is usually highly variable, from a few millimeters to occupying most of the thorax, and it is not nec- essarily related to the size of the diaphragmatic defect (5,11,20); 20 per cent of BHs are contained by a sac, and the remainder show direct communication between thorax and abdominal cavity (21). BHs typically contain omental fat, which can be accompanied by the stomach, spleen, colon, and even the small intestine (10,11,16,20,22,23). The involvement of the liver, gallbladder, pancreas, kidney, or retroperitoneal fat is rare (5), and there has been no report of a lung component in adult BH (10).…”

Section: Discussionmentioning

confidence: 99%

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Posterolateral Bochdalek diaphragmatic hernia in adults

Garófano-Jerez¹,

López-González

Valero-González

et al. 2011

Rev. esp. enferm. dig.

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Bochdalek hernias (BHs) are produced in the posterolateral area of the diaphragm. They are generally congenital, appearing in childhood, but are also detected in asymptomatic adult patients seeking medical attention for other reasons. Computed tomography (CT) or magnetic resonance imaging (MRI) is used for the correct diagnosis of the hernia type and for its localization, facilitating its management and the choice of treatment. We describe three cases of Bochdalek hernia, two on the right side and one bilateral, which was larger on the right than left side. All of these hernias contained only omental fat. In one patient, the right kidney was adjacent to the diaphragmatic defect but remained within the abdomen. The patients showed no symptoms and were not surgically treated. Examination by multislice CT with the possibility of coronal and sagittal reconstruction should be considered the standard method for diagnosing this entity. MRI in T1 is highly valuable to evaluate fat-containing chest lesions. The incidental finding of BH in asymptomatic adults is increasing, thanks to the wider application of new imaging techniques.

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Section: Discussionmentioning

confidence: 99%

“…One of our patients was hospitalized for intense epigastric pain, but its relationship with the BH could not be demonstrated. There have been rare reports of late presenting BH with gastric volvulus, spleen rupture, obstruction, and gastrointestinal perforation (23,25,26).…”

Section: A B Cmentioning

confidence: 99%

Posterolateral Bochdalek diaphragmatic hernia in adults

Garófano-Jerez¹,

López-González

Valero-González

et al. 2011

Rev. esp. enferm. dig.

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“…4 There is a general belief, however, that the incidence of BH is much higher than this as supported by two recent reports. 5,6 The high incidence of BH in these studies has been attributed to the high clarity in the definition of structural abnormality with multidimensional CT. The diagnosis of BH is often difficult to make in adults due to the wide variation in their presenting symptoms and the rarity of this hernia defect.…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted thoracoscopic repair of a late-onset Bochdalek hernia: a case report

et al. 2018

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Bochdalek hernia (BH) is a major malformation that consists of a postero-lateral diaphragmatic defect through which abdominal contents can migrate into the thorax. It is most commonly a neonatal pathology associated with significant morbidity and mortality. Rarely, this type of congenital diaphragmatic hernia (CDH) presents later in life, some even in adulthood. Indications for surgery are not clear even though the majority of authors, being aware of the possible severe complications, recommend surgical correction in all cases. Many surgical approaches have been tried for this pathology, both open (laparotomic or thoracotomic) and minimally invasive (laparoscopic or thoracoscopic). We report a case of a late-onset BH corrected with a robot-assisted thoracoscopic procedure. The use of robotic technology for CDH has never been described to date.

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“…Most larger and symptomatic hernias are diagnosed during the neonatal period, because the herniation of abdominal organs causes severe respiratory distress. However, asymptomatic Bochdalek hernias can be incidentally found in 10.5% of adults undergoing chest or abdominal CT examinations (67). CXR may fail to show the herniation, whereas CT and MRI allow accurate detection and characterization of Bochdalek hernia and such potential complications as bowel incarceration, strangulation, or perforation (68,69).…”

Section: Bochdalek Herniamentioning

confidence: 99%

“…Multiplanar CT and MRI images are useful for showing the diaphragmatic defect (Fig. 15) and the contents of the hernia sac (67,71). This defect is the key finding for differentiating a Bochdalek hernia from diaphragmatic eventration or a diaphragmatic lipoma or liposarcoma (68).…”

Section: Bochdalek Herniamentioning

confidence: 99%