Strangulated Bochdalek hernia: Approach of management in emergency setting

Chandran, Pradeep Chand and Jothi, Dinesh Baithma and Hayati, Firdaus and Ng, Chiak Yot (2021) Strangulated Bochdalek hernia: Approach of management in emergency setting. Gazi Medical Journal, 32 (3). pp. 439-441. ISSN 2147-2092, DOI https://doi.org/10.12996/gmj.2021.99.

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Abstract

Bochdalek hernia is a type of congenital diaphragmatic hernia that primarily manifests in children however in rare instances they do manifest in adulthood spontaneously or after physical exertion. We report a case of a left-sided Bochdalek hernia in an adult who presented with left-sided chest pain and worsening symptoms of dyspnea. His chest radiograph revealed dilated small bowel loops in the left hemithorax causing a mediastinal shift. A computed tomography done revealed a posterolateral diaphragmatic defect through which the abdominal viscera had herniated. He was subsequently intubated due to severe respiratory distress. The patient underwent an emergency laparotomy which revealed a large 10 cm posterolateral diaphragmatic defect with herniation of small bowel, spleen and transverse colon. The small bowel was gangrenous and perforated therefore a primary repair of the defect with nonabsorbable sutures was done. Gangrenous bowel was resected and primary anastomosis was done. Postoperatively, the patient had significant clinical improvement and was discharged a week later with no immediate complications.

Item Type: Article
Funders: UNSPECIFIED
Uncontrolled Keywords: Agenesis of hemidiaphragm; Bochdalek hernias; Congenital diaphragmatic defect; Congenital diaphragmatic hernias; Spiral computed tomography
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine
Divisions: Faculty of Medicine > Surgery Department
Depositing User: Ms Zaharah Ramly
Date Deposited: 29 Aug 2022 07:50
Last Modified: 29 Aug 2022 07:50
URI: http://eprints.um.edu.my/id/eprint/35173

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