Symptomatic Left-Sided Bochdalek Hernia in the Adult: A Case Report and Literature Review

A Bochdalek hernia, a type of diaphragmatic hernia, is a congenital hernia that typically presents on the left posterolateral diaphragm. It typically presents in early childhood as respiratory or gastrointestinal symptoms and diagnosis is confirmed by chest X-ray in pediatric patients. In many cases, treatment is surgical with mesh-based hernia repair. In children, surgical treatment is performed to prevent complications of pulmonary hypoplasia; whereas, in adults, surgical correction of the hernia is done for symptomatic management. We present a case of an 81-year-old female who came in with complaints of shortness of breath, nausea and vomiting, who was diagnosed with Bochdalek hernia on abdominal CT. Although a candidate for surgery, the patient decided to pursue conservative management. Our case emphasizes the importance of clinical suspicion and prompt imaging diagnosis in cases of older patients presenting with respiratory or gastrointestinal symptoms; this case also demonstrates management of Bochdalek hernia without surgical intervention.