Herniation of the Right Renal Pelvis through a Posterolateral Diaphragmatic Defect (Bochdalek Hernia)

Shekar, P. Ashwin; Reddy, Dinesh; Kochhar, Gaurav; Dumra, Anuj; Ks, Shivakumar

doi:10.1016/j.urology.2019.12.009

Cited by 3 publications

(4 citation statements)

References 10 publications

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“…In two cases diaphragmatic defect was repaired by an absorbable mesh (11%) [ 31 , 32 ]. A composite mesh was used in three patients (16%) [ 27 , 33 , 34 ]. One case did not report the type of mesh [ 35 ].…”

Section: Resultsmentioning

confidence: 99%

A systematic review on diagnostics and surgical treatment of adult right-sided Bochdalek hernias and presentation of the current management pathway

Ramspott

Jäger

Lechner

et al. 2021

Hernia

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Purpose Bochdalek hernia is a congenital diaphragmatic hernia. The incidence in adults is estimated around 0.17%. Right-sided hernias are much more seldom than left-sided ones because of faster closure of the right pleuroperitoneal canal and the protective effect of the liver. Due to its rarity, there have been no large prospective or retrospective studies following great need for evidence-based diagnostics and treatment strategies. In this systematic review, we evaluated the current evidence of diagnostics, treatment, and follow-up of adult right-sided Bochdalek hernias. Methods According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines a systematic literature review was conducted in PubMed and Cochrane library from 2004 to January 2021. The literature search included all studies with non-traumatic right-sided Bochdalek hernias. Literature on left- or both-sided, pregnancy-associated, pediatric, and other types of hernias were explicitly excluded. Quality assessment of the included studies was performed. Results Database search identified 401 records. After eligibility screening 41 studies describing 44 cases of right-sided non-traumatic Bochdalek hernias in adulthood were included for final analysis. Based upon the systematic literature review, the current diagnostic, therapeutic, and follow-up management pathway for this rare surgical emergency is presented. Conclusion This systematic review underlined that most studies investigating management of adult non-traumatic right-sided Bochdalek hernias are of moderate to low methodological quality. Hernias tend to occur more frequently in middle-aged and older women presenting with abdominal pain and dyspnea. A rapid and accurate diagnosis following surgical repair and regular follow-up is mandatory. High-quality studies focusing on the management of this rare entity are urgently needed.

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Section: Resultsmentioning

confidence: 99%

A systematic review on diagnostics and surgical treatment of adult right-sided Bochdalek hernias and presentation of the current management pathway

Ramspott

Jäger

Lechner

et al. 2021

Hernia

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“…The defect was then reinforced with composite mesh. 8 It was not clear from their case report if a ureteric stent was placed. The authors, while discussing this case with other colleagues, came across an idea of a nephrostomy insertion with a later attempt to realign the proximal herniated and the distal non-herniated ureter by an antegrade stent alone or with an assistance of a retrograde stent (railroading); however this technique was not used by them but can always be considered for urologist coming across similar cases in the future.…”

Section: Discussionmentioning

confidence: 99%

“…The latter is typically reserved for the patient with good-functional capacity and performance status with few comorbidities. 4,5,8 Despite this, due to a lack of cases and thus no highlevel evidence, there is no accepted gold-standard to treat such patients.…”

Section: Discussionmentioning

confidence: 99%

A Rare Cause of Hydroenphrosis: Case Presentation of an Intrathoracic Herniated Ureter

Alkhafaji

Abusada

Jones

et al. 2021

Journal of Endoluminal Endourology

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BackgroundThoracic ureteric herniation is an uncommon finding with a varying presentation. Since its first documen-tation in 1958, few case reports have been published, and there is no consensus on its management. This condition is typically asymptomatic, with most cases identified incidentally from cross-sectional imaging or discovered intra-operatively.As a result of differing presentations and a lack of consensus or evidence of best practice, this rare finding’s management is not defined. This can range from adopting a conservative approach to more invasive measures such as ureteric stenting or pyeloplasty to repair the thoracic hernia.The authors present a case of thoracic ureteric herniation in a 74-year-old male presenting with right-sided abdominal pain. This patient was known to have a diaphragmatic hernia following pulmonary fibrosis investigations and chronic obstructive pulmonary disease (COPD). At presentation, there was acute kidney injury (AKI), and subsequent computed topography (CT) demonstrated right-sided hydronephrosis and perinephric fat stranding. This was caused by ureteric obstruction with a transition point at the site of thoracic herniation. The patient was successfully managed with retrograde ureteric stent insertion.This case report aims to highlight variance in the presentation of ureteric thoracic herniation and discuss management options. There is no consensus on management for this condition and choices dependant on specific symptoms and patient factors to the best of our knowledge.

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“…Hernia repairs generally involve either direct diaphragmatic sutures or mesh-augmented closures [ [29] , [30] , [31] ]. Some cases may combine mesh with sutures or use clips for additional support [ 32 , 33 ]. Modern surgical advancements have made minimally invasive techniques such as thoracoscopic and laparoscopic repairs increasingly viable.…”

Section: Adult Bochdalek Herniamentioning

confidence: 99%

Incidental discovery of a giant congenital diaphragmatic hernia in an adult: A case report and literature review

Taheriniya,

Maghsoudi,

Chaghamirzayi

2024

International Journal of Surgery Case Reports

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Herniation of the Right Renal Pelvis through a Posterolateral Diaphragmatic Defect (Bochdalek Hernia)

Cited by 3 publications

References 10 publications

A systematic review on diagnostics and surgical treatment of adult right-sided Bochdalek hernias and presentation of the current management pathway

A systematic review on diagnostics and surgical treatment of adult right-sided Bochdalek hernias and presentation of the current management pathway

A Rare Cause of Hydroenphrosis: Case Presentation of an Intrathoracic Herniated Ureter

Incidental discovery of a giant congenital diaphragmatic hernia in an adult: A case report and literature review

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