A Case of Adult Bochdalek Hernia causing Small Intestinal Perforation in the Thoracic Cavity

Kazuhiro Ashikawa, Masafumi Katayama*, Koji Kamio*, Takayuki Asano* and Hiroyuki Komoriyama*

Deapartment of Surgery, Susono Red Cross Hospital
Department of Gastrointestinal and General Surgery, St. Marianna University Yokohama City Hospital*

Most Bochdalek hernias are observed in infancy, and adult cases are very rare. We report such a case perforating the small intestine in an adult suffering serious clinical complications. A 72-year-old woman admitted for nausea, abdominal pain, underwent emergency surgery for a left diaphragmatic hernia with small-intestine incarceration and thoracic cavity perforation. A defect in the left diaphragm was diagnosed as a Bochdalek hernia entered by 40 cm of the ileum in the left chest. Hernia strangulation caused a 15 mm punch in the thoracic cavity, necessitating partial small-intestine resection including the perforation site. The diaphragmatic defect was closed with interrupted sutures and herniation repaired by closing the left Bochdalek foramen. Such subjects should undergo surgery as soon as possible after diagnosis.

Key words
Bochdalek hernia, adult Bochdalek hernia, perforation

Reprint requests
Kazuhiro Ashikawa Deapartment of Surgery, Susono Red Cross Hospital
713 Sano, Susono, 410-1118 JAPAN

Accepted
March 24, 2010

To read the PDF file you will need Abobe Reader installed on your computer.