Repair of a giant diaphragmatic hernia using the dual approach
Affiliations
Affiliations
- 1Kuwait University, Faculty of Medicine, Kuwait City, Kuwait.
- 2Al Amiri Hospital, Department of Surgery, Kuwait City, Kuwait.
Abstract
Bochdalek hernias are diaphragmatic defects seen in pediatrics. About 5-25% of the cases are diagnosed in adulthood, and present with symptoms of chest and abdominal problems. This is a case of an 18-year-old male who presented to the emergency department with epigastric pain, vomiting and dyspnea. Most of the left-sided organs had herniated to the left chest cavity. Immediate surgery was performed. The stomach, spleen and colon were reduced into the abdominal cavity. The diaphragm defect was repaired laparoscopically, but there were limitations due to inadequate space, leading to difficult visualization of the posterior diaphragmatic leaflet. A thoracoscopic approach was taken where we saw the left kidney herniated through the repair site posteriorly. It was reduced and the defect was closed. The early diagnosis of Bochdalek hernias is important to prevent stomach/intestinal strangulation. Laparoscopic surgeons need to be prepared for a thoracic approach in giant congenital diaphragmatic hernias.
Similar articles
Ohtsuka Y, Suzuki TH.Acute Med Surg. 2016 Nov 10;4(2):209-212. doi: 10.1002/ams2.249. eCollection 2017 Apr.PMID: 29123864 Free PMC article.
Thoracoscopic-assisted repair of a bochdalek hernia in an adult: a case report.
Tokumoto N, Tanabe K, Yamamoto H, Suzuki T, Miyata Y, Ohdan H.J Med Case Rep. 2010 Nov 17;4:366. doi: 10.1186/1752-1947-4-366.PMID: 21083878 Free PMC article.
Miyasaka T, Matsutani T, Nomura T, Hagiwara N, Chihara N, Takahashi K, Mishima K, Taniai N, Yoshida H.Surg Case Rep. 2020 Sep 29;6(1):233. doi: 10.1186/s40792-020-01003-8.PMID: 32990881 Free PMC article.
Anaya-Ayala JE, Naik-Mathuria B, Olutoye OO.J Pediatr Surg. 2008 Mar;43(3):E35-9. doi: 10.1016/j.jpedsurg.2007.11.015.PMID: 18358272 Review.
Emergency surgery due to diaphragmatic hernia: case series and review.
Testini M, Girardi A, Isernia RM, De Palma A, Catalano G, Pezzolla A, Gurrado A.World J Emerg Surg. 2017 May 18;12:23. doi: 10.1186/s13017-017-0134-5. eCollection 2017.PMID: 28529538 Free PMC article. Review.
Cited by
Thoracolaparoscopic repair of diaphragmatic hernias.
Kumar A, Parshad R, Suhani, Bhattacharjee HK, Sharma R.Indian J Thorac Cardiovasc Surg. 2021 Sep;37(5):558-564. doi: 10.1007/s12055-021-01142-z. Epub 2021 Feb 13.PMID: 34511764 Free PMC article.
Oppelt PU, Askevold I, Bender F, Liese J, Padberg W, Hecker A, Reichert M.Hernia. 2021 Apr;25(2):479-489. doi: 10.1007/s10029-020-02147-0. Epub 2020 Feb 29.PMID: 32112200 Free PMC article.
KMEL References
References
-
- Mullins ME, Stein J, Saini SS, Mueller PR. Prevalence of incidental Bochdalek’s hernia in a large adult population. AJR Am J Roentgenol 2001;177:363–6. - PubMed
-
- Salacin S, Alper B, Cekin N, Gulmen MK. Bochdalek hernia in adulthood: a review and an autopsy case report. J Forensic Sci 1994;39:1112–6. - PubMed
-
- Nitecki S, Mar-Maor JA. Late presentation of Bochdalek hernia: our experience and review of the literature. Isr J Med Sci 1992;28:711–4. - PubMed
-
- Topor L, Pătrăncuş T, Caragaţa R, Moga A. Left congenital diaphragmatic hernia—case report. Chir (Bucur) 2015;110:84–7. - PubMed
-
- Chatterjee S, Mitra A, Sarkar S, Prasad S. Acute intestinal obstruction: a rare presentation of left sided adult congenital diaphragmatic hernia. Hellenic J Surg 2015;87:427–9.
-
- Asensio JA, Demetriades D, Rodriguez A. Injury to the diaphragm In: Mattock KL, Feliciano DU, Moore EE, eds. Trauma. New York: McGraw Hill, 1999;603–31.
-
- Brown SR, Horton JD, Trivette E, Hofmann LJ, Johnson JM. Bochdalek hernia in the adult: demographics, presentation, and surgical management. Hernia 2011;15:23–30. Epub 2010 Jul 8. - PubMed