A Case of Adult Right-sided Bochdalek Hernia with Panperitonitis due to Perforation of Duodenal Ulcer

Nozomi Idota, Kazuo Hatsuse, Akifumi Watanabe, Yasuhiro Ohbuchi, Hideki Aoki, Minoru Kakihara, Takashi Ichikura, Hidetaka Mochizuki

Department of Surgery I, National Defense Medical College

We report a case of adult right-sided Bochdalek hernia with concomitant perforation of a duodenal ulcer. A 64-year-old female was admitted to our hospital, complaining of sudden upper abdominal pain. Chest X-ray showed pneumothorax and elevation of the diaphragm in the right chest, and abdominal free air under the left diaphragm. Emergency surgery revealed perforation of a duodenal ulcer, and bowel herniation from the ileal terminus to the transverse colon through the dorsolateral defect of the right diaphragm. The defect was 8×5 cm in size and no hernia sac was detected. The duodenal ulcer perforation site was packed with major omentum. The diaphragm defect was closed with double interrupted sutures. This is apparently the 110th case of adult Bochdalek hernia having been reported in Japan. Adult right-sided Bochdalek hernia is very rare and only 5 cases, including ours, have been reported in Japan.

Key words
Bochdalek hernia, adult Bochdalek hernia, panperitonitis

Reprint requests
Nozomi Idota First Department of Surgery, National Defense Medical College
3-2 Namiki, Tokorozawa-shi, 359 JAPAN

Accepted
November 13, 1996

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