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[Bochdalek diaphragmatic hernia in the elderly: a case report]
T Kugai1, K Sunagawa, E Ikemura
1Division of Surgery, Okinawa Prefectural Miyako Hospital.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|August 1, 1992
Summary
Surgically treating Bochdalek diaphragmatic hernia in an elderly patient resolved intestinal obstruction. The transthoracic approach is recommended for adults due to good outcomes.
Area of Science:
- Thoracic surgery
- Gastroenterology
- Diaphragmatic diseases
Background:
- Bochdalek diaphragmatic hernia (BDH) is common in infants, often causing respiratory distress and high mortality.
- In adults, BDH can present with intermittent intestinal obstruction, requiring surgical intervention.
Observation:
- An 80-year-old woman presented with intermittent intestinal obstruction due to a left-sided Bochdalek diaphragmatic hernia.
- Preoperative imaging (chest roentgenograph and CT scan) confirmed herniated bowel within the left thoracic cavity.
Findings:
- The patient underwent successful surgical repair involving reduction of the herniated large bowel and excision of the hernial sac.
- A 5x6 cm posterolateral diaphragmatic defect was closed using interrupted mattress sutures.
- The patient remained asymptomatic 6 months post-surgery.
Implications:
- Surgical treatment of Bochdalek diaphragmatic hernia in adults yields favorable postoperative results.
- A transthoracic approach is preferred for adult BDH repair, facilitating bowel reduction and diaphragmatic defect closure.
- This approach minimizes the risk of significant gastrointestinal complications requiring further repair.