Strangulated Bochdalek Hernia in Adults: Timely Recognition and Surgical Intervention Can Prevent a Lethal Outcome

Abstract

Bochdalek hernias are rare diaphragmatic hernias most commonly seen in pediatric populations. Adults with this condition may be asymptomatic or present with gastrointestinal symptoms such as abdominal pain, pressure, choking, or dysphagia. Computed tomography imaging is a gold standard in diagnosing the condition. The definitive treatment is surgery, recommended and encouraged for asymptomatic patients as well to reduce the risk of future complications. Whilst the approach to surgical management differs on a case-by-case basis, the main goal is to reduce the herniating organ and repair the defect. It is important to note that in severe cases, intestinal obstruction and strangulation may occur. We present a unique case of this very phenomenon in a patient diagnosed and treated as a case of strangulated Bochdalek hernia. We aim to highlight the importance of diagnosing this condition as clinical symptoms may be non-specific, and rapid surgical intervention is necessary.

Asymptomatic Bochdalek's Hernia in an Adult: A Case Report

“…Congenital diaphragmatic hernias (CDH) occur with an incidence of one in 2,000-3,000 newborns and are mostly diagnosed and treated in early childhood [1,2]. Bochdalek's hernia is the most common type of CDH, which consists of a defect in the posterolateral aspect of the diaphragm, predominantly on the left side (75%-90%) [3,4]. It was first described by the Czech anatomist Vincent Alexander Bochdalek in 1848 [1].…”