Bochdalek Hernia and Partial Diaphragmatic Agenesis: Pedicled Intercostal Muscle Flap and Mesh Repair in a Young...

Area of Science:

• Medical Science
• Surgical Science
• Pediatric Surgery

Background:

• Congenital Bochdalek hernia (BH) is a rare condition, primarily affecting infants with an incidence of 1:3,000 live births.
• Adult presentation of BH is exceptionally uncommon, with most cases diagnosed in the pediatric age group.
• Surgical repair is the standard treatment, involving thoracic, abdominal, or thoraco-abdominal approaches, often with diaphragmatic reconstruction for agenesis.

Observation:

• This report details a rare case of a congenital Bochdalek hernia in a young adult.
• The patient presented with an unusual manifestation of BH, persisting asymptomatically into adulthood.
• A significant comorbidity of sickle cell disease was noted in this adult BH patient.

Findings:

• This case represents one of only 10 reported instances of BH with partial diaphragmatic agenesis.
• The co-occurrence of adult BH, partial diaphragmatic agenesis, and sickle cell disease is unprecedented in medical literature.
• The study discusses the rarity, atypical presentation, and management strategies for this complex clinical scenario.

Implications:

• This case expands the understanding of congenital Bochdalek hernia presentations beyond infancy.
• It underscores the importance of considering rare diagnoses in adult patients with atypical symptoms.
• The findings may inform surgical approaches and management protocols for similar complex cases in the future.