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Bochdalek Hernia in an Adult with Upper Gastrointestinal Bleeding
Mohammed Al-Dugdugi1, Abdulhameed Alhazmi2, Abdulhadi Khaliel1
1Department of Endoscopy, Division of Gastroenterology, King Fahad Central Hospital, Jizan, Saudi Arabia.
Insights
Bochdalek hernia (BH) is often fatal in infants but usually asymptomatic in adults. This case highlights rare adult BH complications: upper GI bleeding and pancreatitis, successfully managed with early diagnosis and surgical repair.
Area of Science:
- Medical Case Reports
- Surgical Gastroenterology
- Thoracic Surgery
Background:
- Bochdalek hernia (BH) presents a high mortality risk in neonates due to respiratory compromise.
- In adults, BH is typically asymptomatic and incidentally discovered, though rare complications can occur.
Abstract:
Bochdalek hernia (BH) can be a life-threatening condition in infants. Approximately 85.3% of newborns with a BH are immediately at high risk and have a high mortality rate due to respiratory insufficiency [Kocakusak et al.: Hernia 2005;9: 284-287]. However, BH is almost asymptomatic in adults and discovered only incidentally [Wilkins et al.: Clin Imaging 1994;18: 224-229]. Complicated BH in adults might present with visceral incarceration and lethal complications. Upper gastrointestinal bleeding and acute pancreatitis are rarely reported in the literature as complications of BH in adults. Here we report the case of a 42-year-old male who presented with upper gastrointestinal bleeding and acute pancreatitis. He was found to have abdominal visceral organ herniation to the posterior right thoracic cavity. His diagnosis was achieved early and with a close follow-up, we succeeded in stabilizing the patient's condition. Then he was subjected to reconstructive thoracotomy for hernial repair and restoring abdominal viscera.
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