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Bochdalek hernia in a soldier.

¹The Princess Mary Hospital, RAF Akrotiri, BFPO 57.

Journal of the Royal Naval Medical Service

|August 9, 2006

Summary

Adult congenital diaphragmatic hernias are rare but can cause serious complications like bowel obstruction. Surgical repair via laparotomy, combined with epidural analgesia and physiotherapy, led to an uncomplicated recovery in this case.

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Area of Science:

General Surgery
Thoracic Surgery
Gastrointestinal Surgery

Background:

Congenital diaphragmatic hernias (CDH) are typically diagnosed in infancy.
Adult presentation of CDH is uncommon, often presenting with non-specific symptoms.
Delayed diagnosis can lead to significant morbidity.

Observation:

A soldier presented with acute bowel obstruction and respiratory distress.
Diagnostic workup revealed a congenital diaphragmatic hernia as the underlying cause.
The patient was managed in a military hospital setting.

Findings:

Surgical repair of the diaphragmatic hernia was successfully performed using laparotomy.
Post-operative recovery was uncomplicated.
Effective pain management with epidural analgesia and early physiotherapy were key components of care.

Implications:

This case highlights the importance of considering CDH in adults with abdominal and respiratory symptoms.
Laparotomy is a viable surgical approach for adult CDH repair.
Multimodal post-operative care, including epidural analgesia and physiotherapy, facilitates recovery.

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