Bochdalek hernia (Acute gastric obstruction and laparoscopic approach)

Rafael Diaz-Nieto,Alvaro Naranjo-Torres

doi:10.4236/health.2011.310102

Abstract

Bochdalek hernia is a rare clinical entity which consist of a lack of development of the diaphragm. Its diagnosis is more common in children and in relation to respiratory symptons. But it is also possible to appear in adulthood and usually related with acute digestive problems. Due to acute presentation often require emergency surgery. After reviewing the current literature, laparoscopic approach seems to be the technique of choice, with or without mesh placement. We report a new case of a young man with acute obstruction syndrome and laparoscopic treatment.

Highlights

Bochdalek hernia is a congenital pathology which consists of an uncomplete development of the diaphragm, which entails the persistence of a hole or weakness in the posterolateral side of the diaphragm
Diagnosis of Bochdalek hernia in adulthood is extremely rare and most cases founded in the literature were diagnosed as acute gastrointestinal problems compared to cardiorrespiratory symptoms, unlike what happens in childhood [5]
We present the case of a 28 years-old man without medical or surgical pathology; who is examinated in the emergency room due to a lumbar and epigastric pain since two days

Summary

INTRODUCTION

Bochdalek hernia is a congenital pathology which consists of an uncomplete development of the diaphragm, which entails the persistence of a hole or weakness in the posterolateral side of the diaphragm This lack of development can take place at different times of embryogenesis between the sixth and tenth week. From a clinical point of view, 90% are diagnosed in childhood and usually asociated with pulmonary hypoplasia due to the compression of the lung This situation carry on acute hemodinamic and respiratory failure that require treatment. Diagnosis of Bochdalek hernia in adulthood is extremely rare and most cases founded in the literature were diagnosed as acute gastrointestinal problems compared to cardiorrespiratory symptoms, unlike what happens in childhood [5]. Due to in adulthood we are used to find an emergency problem and the differential diagnosis with traumatic rupture of the diaphragm is not always possible, this clinical entity is usually indication of emergency surgery because of the potential complications arising from it [7]

CASE REPORT

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DISCUSSION

CONCLUSION