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An Unexpected Adverse Event during Colonoscopy Screening: Bochdalek Hernia
Joon Seop Lee1,2, Eun Soo Kim1,2, Min Kyu Jung1,2
1Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
Summary
Bochdalek hernia (BH), a diaphragmatic defect, is rarely diagnosed in adults. This case highlights the first adult BH discovered incidentally during a colonoscopy, involving herniated omentum and colon.
Area of Science:
- Gastroenterology
- Thoracic Surgery
- Diagnostic Imaging
Background:
- Bochdalek hernia (BH) involves herniated abdominal contents through the diaphragm's posterolateral segment.
- BH is typically diagnosed in the prenatal or neonatal period.
- Adult presentation of BH is uncommon and often asymptomatic or presents with vague symptoms.
Observation:
- A 41-year-old woman experienced chest and abdominal pain during a colonoscopy.
- Radiography revealed colonic contents in the left thoracic cavity.
- CT scan confirmed a left posterolateral diaphragmatic defect with herniated omentum and colon.
Findings:
- Successful thoracoscopic repair of the diaphragmatic defect and omentum.
- The patient experienced an uncomplicated recovery post-surgery.
Implications:
- This case represents the first reported instance of adult Bochdalek hernia diagnosed during a routine colonoscopy.
- Highlights the importance of considering rare diagnoses in adult patients with atypical presentations.
- Suggests potential for incidental diagnosis of BH during gastrointestinal endoscopic procedures.
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