A Case Report of a Bochdalek's Hernia in an Adult with Gastric Perforation

Hirokazu Suwa, Yutaka Nagahori, Tetsuya Takahashi, Harumi Yamamoto, Shunichi Osada, Toru Kubota, Yoshirou Obi, Tetsuo Abe, Itaru Endo* and Hiroshi Shimada*

Department of Surgery, Yokohama Minato Red Cross Hospital
Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine*

We report an adult case of a Bochdalek's hernia with gastric perforation. A 65-year-old man admitted for abdominal pain and septic shock was found in chest radiography and abdominal computed tomography to have a diaphragmatic hernia with gastrointestinal perforation. We conducted partial gastrectomy, hernial orifice closure, and abdominal drainage. Bochdalek's hernia accounts for 70% of congenital diaphragmatic hernia, although occurrence in an adult is rare. Since impacting or perforation of the herniated organ may rapidly worsen, we recommend early surgery regardless of whether the patient is a symptomatic.

Key words
diaphragmatic hernia, Bochdalek's hernia, gastric perforation

Reprint requests
Hirokazu Suwa Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine
3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 JAPAN

Accepted
June 16, 2010

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