Laparoscopic repair of Bochdalek hernia in an adult

Diaphragmatic hernias of the Bochdalek type are rare in adults. The diagnosis may be made with radiography of the chest in an asymptomatic person or in a person with respiratory and/or gastrointestinal symptoms. It has been mistaken for pleural effusion, empyema, lung cysts, and pneumothorax. A 38-year-old woman presented with epigastric pain and a persistent cough of 2 months' duration. A chest radiograph showed bowel loops in the left side of the chest. On laparoscopy, two defects, measuring 10 and 4 cm, respectively, were seen in the left hemidiaphragm. The herniated fundus of the stomach was reduced and the defect repaired with Gore-Tex mesh (W. L. Gore & Associates, Inc., Flagstaff, AZ, U.S.A.). The patient had an uneventful recovery. Laparoscopic repair of the rare Bochdalek hernia is feasible.