Adult Bochdalek hernia simulating left pleural effusion: a review and a case report

Novakov, Ivan; Paskalev, G

doi:10.2478/v10153-010-0019-9

Cited by 6 publications

(14 citation statements)

References 16 publications

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“…[ 5 ] The misdiagnosis includes hydropneumothorax, hemothorax, empyema, pleural effusion, and pneumonia. [ 16 17 18 19 ] The consequence of misdiagnosis is a delay in appropriate management, leading to a potential risk of strangulation; some of these unfortunate patients, in whom an intercostal tube is inadvertently placed, could have serious consequences. [ 4 16 17 18 19 ] In view of the risk of misdiagnosis, some have suggested to look for additional clues in patients who present with respiratory symptoms and are suspected to have BH.…”

Section: Misdiagnosismentioning

confidence: 99%

“…[ 3 15 ] Unfortunately, some of these patients are misdiagnosed, leading to serious consequence. [ 16 17 18 19 ] Historically these patients have been managed by laparotomy[ 1 4 5 20 21 22 ] or thoracotomy,[ 1 6 23 ] and primary repair with or without mesh reenforcement was performed. With the expansion of laparoscopic experience in various intraabdominal surgeries, there are several reports now of BH being successfully managed by a laparoscopic approach.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic repair of bochdalek diaphragmatic hernia in adults

Machado

2016

North Am J Med Sci

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Bochdalek hernia (BH) is an uncommon form of diaphragmatic hernia. The rarity of this hernia and its nonspecific presentation leads to delay in the diagnosis, with the potential risk of complications. This review summarizes the relevant aspects of its presentation and management, based on the present evidence in the literature. A literature search was performed on PubMed, Google Scholar, and EMBASE for articles in English on BH in adults. All case reports and series from the period after 1955 till January 2015 were included. A total of 180 articles comprising 368 cases were studied. The mean age of these patients was 51 years (range 15-90 years) with a male preponderance of 57% (211/368). Significantly, 6.5% of patients were above 70 years, with 3.5% of these being above 80 years. The majority of the hernias were on the left side (63%), with right-sided hernias and bilateral occurring in 27% and 10%, respectively. Precipitating factors were noted in 24%, with 5.3% of them being pregnant. Congenital anomalies were seen in 11%. The presenting symptoms included abdominal (62%), respiratory (40%), obstructive (vomiting/abdominal distension; 36%), strangulation (26%); 14% of them were asymptomatic (detected incidentally). In the 184 patients who underwent surgical intervention, the surgical approach involved laparotomy in 74 (40.27%), thoracotomy in 50 (27.7%), combined thoracoabdominal approach in 27 (14.6%), laparoscopy in 23 (12.5%), and thoracoscopic repair in 9 (4.89%). An overall recurrence rate of 1.6% was noted. Among these patients who underwent laparoscopic repair, 82% underwent elective procedure; 66% underwent primary repair, with 61% requiring interposition of mesh or reenforcement with or without primary repair. The overall mortality was 2.7%. Therefore, BH should form one of the differential diagnoses in patients who present with simultaneous abdominal and chest symptoms. Minimal access surgery offers a good alternative with short hospital stay and is associated with minimum morbidity and mortality.

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Section: Misdiagnosismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Laparoscopic repair of bochdalek diaphragmatic hernia in adults

Machado

2016

North Am J Med Sci

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“…There is no established consensus for choosing an approach, although the approach should be selected on a case-by-case basis. Transabdominal, transthoracic, and combined thoracoabdominal routes are different approaches [ 10 , 11 ]. There are advantages and disadvantages for each approach.…”

Section: Case Presentationmentioning

confidence: 99%

Right-sided Bochdalek hernia in an elderly adult: a case report with a review of surgical management

Moro¹,

Kawahara²,

Muneoka³

et al. 2017

surg case rep

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BackgroundBochdalek hernias are one of the most common types of diaphragmatic hernia, with most cases diagnosed during the neonatal period. In contrast, diagnosis of a Bochdalek hernia in an adult is rare and is typically observed on the left side of the diaphragm. Even more rare is the diagnosis of a right-sided Bochdalek hernia in an adult, where there is concurrent visceral malformation in most cases.Case presentationWe describe a case of an 89-year-old female who presented with abdominal pain. An abdominal computed tomography (CT) scan showed decreased intravenous contrast uptake and thickening of the wall of herniated small intestine through the right side of the diaphragm, which led to the diagnosis of a strangulated diaphragmatic hernia. The patient underwent emergent laparotomy and required a partial resection of the necrotic ileum and a hernia repair with direct closure. Interestingly, in this case, organ malformation was not observed. The patient was discharged approximately 2 weeks after surgery without complication.ConclusionsAdult right-sided Bochdalek hernia with strangulation in the absence of hepatic atrophy is a rare entity. Considering the severity of this condition, accurate diagnosis and proper treatment are needed. A tailored operative approach is required on an individual case basis.

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“…Bochdalek hernias (BH) are a congenital posterolateral diaphragmatic defect, which were first described by Bochdalek in 1848 [1]. Once diagnosed, Bochdalek hernias should be surgically treated during the neonatal period.…”

Section: Introductionmentioning

confidence: 99%

Video-assisted thoracoscopic surgery for adult Bochdalek hernia: a case report

Shen

Jiao

Xiong

et al. 2016

J Cardiothorac Surg

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BackgroundBochdalek hernia is a type of congenital diaphragmatic hernia that typically presents in childhood, while this diseases is extremely rare in adults.Case presentationWe review a case of a 63-year-old man with a left-sided Bochdalek hernia who was experiencing occasional pain at the left side of his chest for 8 months. The diagnosis of Bochdalek hernia was made by chest computed tomography. A part of the retroperitoneal adipose tissue was herniated into the left thoracic cavity through the diaphragmatic defect. The hernia was treated via video-assisted thoracoscopic surgery and he made an uneventful recovery.ConclusionsWe report a rare case of a left-sided Bochdalek hernia for which our patient was treated successfully via video-assisted thoracoscopic surgery. Even though rare, this disorder should be recognised, examined and treated appropriately to avoid complications.

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Adult Bochdalek hernia simulating left pleural effusion: a review and a case report

Cited by 6 publications

References 16 publications

Laparoscopic repair of bochdalek diaphragmatic hernia in adults

Laparoscopic repair of bochdalek diaphragmatic hernia in adults

Right-sided Bochdalek hernia in an elderly adult: a case report with a review of surgical management

Video-assisted thoracoscopic surgery for adult Bochdalek hernia: a case report

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