Case Report: Adult Right-Sided Bochdalek Hernia Complicated by Intrathoracic Bowel Perforation
Jan Philipp Ramspott1,2, Stephan Regenbogen1,3, Tarkan Jäger1
1Department of Surgery, Paracelsus Medical University Salzburg, University Hospital Salzburg, Salzburg, Austria.
Right-sided Bochdalek hernia in adults is rare but requires urgent diagnosis and surgery. This case highlights successful emergency management including laparotomy, hemicolectomy, and thoracotomy for a complicated presentation.
Area of Science:
- Diaphragmatic Surgery
- Congenital Abnormalities
- Adult Case Reports
Background:
- Right-sided Bochdalek hernia, a rare adult condition, arises from persistent pleuroperitoneal cavity.
- It often presents emergently, necessitating prompt diagnosis and surgical intervention to mitigate risks.
Observation:
- A 40-year-old woman presented with acute abdominal pain and tachypnea.
- Imaging confirmed a right-sided Bochdalek hernia with intrathoracic bowel perforation and ischemia.
Findings:
- Emergency laparotomy involved hernia reduction, right hemicolectomy, and ileocolic anastomosis.
- Postoperative pleural empyema required subsequent thoracotomy for management.
Implications:
- This case underscores the complexity of managing adult Bochdalek hernias.
- It emphasizes the need for tailored surgical strategies, potentially combining abdominal and thoracic approaches, for optimal outcomes.
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