Left-Sided Bochdalek's Hernia in a Young Adult: A Case Report and Literature Review

Abstract

Purpose Bochdalek's hernia is a type of congenital diaphragmatic hernia occurring secondary to a defect in the posterior attachment of diaphragm. This condition commonly presents with respiratory insufficiency in infants. To date, there are less than 100 cases of Bochdalek's hernia presenting in adults published in the literature. The mainstay treatment of Bochdalek's hernia involves reduction of hernial contents back into the peritoneal cavity with a tensionless graft repair closing the diaphragmatic defect. Case Presentation We present an atypical case of the Bochdalek hernia presenting in a previously healthy 16-year-old male who presented to the Accident and Emergency department with a 2-day history of dysphagia and loss of breath. The Bochdalek hernia was confirmed on computed tomography (CT) imaging and the patient underwent surgical repair with Gore-Tex mesh. Conclusion The report shows a rare case of the Bochdalek hernia in a young adult, successfully managed with a laparotomy.

Delayed presentation of a right congenital diaphragmatic hernia following left congenital diaphragmatic hernia repair in infancy

“…Most of these lesions are diagnosed prenatally, and often are complicated by significant pulmonary hypoplasia resulting in newborn respiratory failure. Late-presenting Bochdalek hernias in children and young adults are less common, but at presentation are usually evident on CXR [12] , [13] , [14] , [15] . The incidence of late-presenting CDH has been reported to vary between 20 and 45 % of all CDH patients in several studies [16] .…”

Longitudinal Follow-Up With Radiologic Screening for Recurrence and Secondary Hiatal Hernia in Neonates With Open Repair of Congenital Diaphragmatic Hernia—A Large Prospective, Observational Cohort Study at One Referral Center

“…Furthermore, two recently published reviews provide an insight into complications and mortality in adults with latepresenting CDH, which was thought to be a harmless situation. With less than 100 cases, left-sided CDH is rarely diagnosed in adults but seems to be correlated with a high rate of gastrointestinal complications and mortality (39). Right-sided CDH is also a rare condition in adults with 44 patients being reported so far.…”

“…There have been few reports on symptomatic hydronephrosis and/or arterial hypertension in patients with herniated kidneys that resolved after surgical repair of the diaphragmatic defect (40). Therefore, CDH containing abdominal viscera is considered to be an emergency in adults that should be repaired as soon as possible to reduce mortality and morbidity (39)(40)(41). On the other hand, the presence of a small Bochdalek hernia containing omentum or fatty tissue has been reported more frequently in CT scans performed for other reasons (42,43).…”

“…On the other hand, acute incarceration with the risk of bowel gangrene and lethal septicemia can result (24). This can also happen after decades in undiagnosed CDH, attributing to a high risk of complications with associated mortality and morbidity (39)(40)(41). In girls, an untreated recurrence may endanger mother and child during future pregnancy.…”

Morgagni hernia presented as Sudden dyspnea in 70 years old man: a case report

“…Mostly it is asymptomatic in adults, and it is frequently discovered as an incidental finding on chest X-ray or Computerized Tomography (CT) scan [ 2 ]. Symptomatic Morgagni hernia in an adult is even rarer, with a wide range of gastrointestinal and respiratory symptoms, making the diagnosis even more challenging [ 3 , 4 ]. We present a case of right-sided Morgagni hernia in a 70-year-old male who presents with sudden dyspnea and was successfully treated with open surgery.…”