An adult case of Bochdalek hernia complicated with hemothorax.
A 53-year-old female with mild shock due to vomiting and abdominal pain visited the emergency room of our hospital. Chest X-ray on admission showed a large amount of left pleural effusion. Thoracentesis revealed hemorrhagic pleural effusion. An upper gastrointestinal series showed interruption of the upper gastric body, but the anal side was not visualized. Contrast X-ray examination of the thoracic cavity via the drainage tube demonstrated intrathoracic herniation through the diaphragm. These findings suggested gastric impaction in the foramen of Bochdalek, and thoracotomy was immediately performed. A black-colored stomach and greater omentum, suggesting necrotic changes, were observed in the thoracic cavity, and there was bleeding from the greater omentum. Resection of the necrotic organs and closure of the hernial orifice were followed by good recovery.
Niwa
Toshiaki
T
Department of Internal Medicine and Bioregulation, Nagoya City University Graduate School of Medical Sciences, 1 Kawasum, Mizuho-cho Mizuho-ku,Nagoya 467-8602, Japan. toniwa@med.nagoya-cu.ac.jp
Nakamura
Atsushi
A
Kato
Takashi
T
Kutsuna
Takeo
T
Tonegawa
Ken
K
Kawai
Atsuro
A
Itoh
Makoto
M
D005260:Female; D006491:Hemothorax / Q000150:complications* / Q000175:diagnosis; D006548:Hernia, Diaphragmatic / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D009336:Necrosis; D009852:Omentum / Q000473:pathology / Q000601:surgery; D012769:Shock / Q000209:etiology; D013270:Stomach / Q000473:pathology / Q000601:surgery