Obstructed Descending Colon Mass Presented With Bochdalek Hernia: A Case Report

Area of Science:

• Gastroenterology
• Thoracic Surgery
• Surgical Pathology

Background:

• Bochdalek hernia in adults is exceptionally rare, with fewer than 30 reported cases, predominantly affecting the right side.
• This condition involves the protrusion of abdominal organs through a defect in the diaphragm.

Observation:

• A 64-year-old female presented with dyspnea, abdominal pain, and nausea.
• Initial imaging revealed a right-sided diaphragmatic hernia containing the liver and right colon.

Findings:

• The patient underwent thoracotomy for diaphragmatic repair, but later developed peritonitis.
• A subsequent laparotomy identified an obstructed and perforated descending colon mass as the primary issue, associated with the Bochdalek hernia.
• The patient unfortunately demised post-operatively.

Implications:

• Increased intra-abdominal pressure, such as from an obstructed colonic mass, can precipitate Bochdalek hernias in adults.
• Thorough investigation is crucial to determine the etiology of symptomatic Bochdalek hernias in adult patients.
• This case underscores the complexity and potential severity of adult Bochdalek hernias, particularly when complicated by bowel obstruction.