Objective:This study investigates the role of preoperative imaging in predicting cases of the intrathoracic stomach in patients with left sided Bochdalek hernia (BH) compared to their postoperative surgical diagnosis.
Methods: A retrospective review was conducted of all left sided BH patients treated at the Children’s Hospital of Chongqing Medical University from Jan 2012 to Dec 2021. According to the time of clinical symptoms, all cases divided into neonatal BH and late onset BH.The number of intrathoracic stomach cases identified on imaging and during surgery were statistically analyzed separately, and the ratio of preoperative imaging to postoperative surgical diagnosis was compared.Meanwhile, the ratio was analyzed separately for neonatal BH and late-onset BH.
Results: A total of 108 patients were identified with left sided BH. The imaging analysis (39/108,36.1%) diagnosed a significantly lower proportion of patients with intrathoracic stomachs as compared to the surgical data (55/108,50.93%) (p = 0.027). The difference was even more apparent in the female patients (P=0.01).For both the neonatal and late onset left sided BH groups, a third of the patients were determined as intrathoracic stomachs by preoperative imaging.
Conclusion: The proportion of intrathoracic stomach (gastric positioning) in left sided BHpatients detected by preoperative imaging was low in comparison to the postoperative data.One third of late onset BHs are confirmed by preoperative imaging examination as intrathoracic stomach, and these patients are more likely to develop severe symptoms