Right-sided Bochdalek hernia in an adult: a case report

Abstract

IntroductionBochdalek hernia is a type of congenital diaphragmatic hernia that typically presents in childhood - the clinical manifestation of symptoms and diagnosis in adults is extremely rare. There are fewer than 20 cases of right-sided Bochdalek hernia reported in adults in the literature.Case presentationWe review a case of a 38-year-old woman with a right-sided Bochdalek hernia who was experiencing abdominal pain and pleural effusion. The diagnosis of Bochdalek hernia was made by chest X-ray and computed tomography. The right lobe of the liver and flexura hepatica of the colon were herniated into the thorax cavity. The hernia was treated via thoracotomy assisted with laparoscopy and she made an uneventful recovery.ConclusionWe report a rare case of a right-sided Bochdalek hernia for which our patient was treated successfully. Even though rare, this disorder should be recognised, examined and treated appropriately to avoid complications.

Adult Bochdalek hernia simulating left pleural effusion: a review and a case report

“…Cases of misinterpretation of X-rays of adult Bochdalek hernias with pneumatocele, lung cysts, pneumotorax, have been reported. 2,[4][5][6][7][8][9]11 The presented case raises some interest because of the incorrect interpretation of the changes observed in the left pleural cavity: two radiologists independently diagnosed this case as left pleural effusion. There have been several similar case reports in the literature of misdiagnosing adult patients with Bochdalek hernia as having pleural effusion.…”

Bochdalek hernia in an octogenarian

“…2 Apart from colon or stomach, other abdominal viscera (liver, gallbladder, small bowel, or kidney) have been found in the hernial sac. 3 Surgical repair is usually recommended in order to prevent future complications like strangulation or intestinal obstruction, but was declined by our patient. The surgery involves reduction of the abdominal contents and repair of diaphragmatic defect via a laparotomy or thoracotomy.…”

“…1,2 Most Bochdalek hernias are diagnosed in children (median age, 6 months) who present with acute respiratory symptoms. 3 Right-sided Bochdalek hernia in adults are only rarely reported and usually give rise to symptoms such as chronic shortness of breath, pleuritic chest pains, and features suggesting a pleural effusion or abdominal symptoms (pain, features of obstruction, or strangulation). [2][3][4][5] The delayed presentation of our patient may be related to his chronic cough being ascribed exclusively to smoking; cough of chronic smokers may also contribute to herniation of abdominal viscera, as suspected in other case reports.…”

“…The surgery involves reduction of the abdominal contents and repair of diaphragmatic defect via a laparotomy or thoracotomy. [3][4][5] Laparoscopic or thoracoscopic repairs are alternatives. 3,5 In summary, clinicians should be prepared to diagnose CDH even in the elderly.…”

A rare case of herniation of liver through incision of cabg: A case report and review of literature

“…12 Laaksonen E and colleagues report a case of right-sided Bochdalek hernia in an adult. 13 Bairagi A and colleagues report a case of Blunt rupture of the right hemidiaphragm with herniation of the right colon and right lobe of the liver. 14 Sheer TA, Runyon BA report a case of recurrent massive steatosis with liver herniation following transplantation.…”