Late presentation of a right Bochdalek hernia with a right intrathoracic stomach and organo-axial torsion.
A postero-lateral hernia through the foramen of Bochdalek is a rare type of congenital diaphragmatic hernia CDH. The incidence of Bochdalek hernia on the right side is 10-20% compared to the left side, and herniation of the stomach into the right pleural cavity is extremely rare. We report a case of right-sided Bochdalek hernia with a right intrathoracic stomach and organo-axial torsion misdiagnosed initially, and treated as a case of hyperactive airway disease. The child had a right thoracotomy, excision of the hernia sac that contained the stomach, greater omentum and part of the liver, reduction of the viscera into the abdominal cavity and simple closure of the diaphragmatic defect. Recovery was uneventful. This case highlights the consequences of late diagnosis and the effectiveness of surgical relief. A new clinico-anatomical classification of Bochdalek hernia is presented.
Al-Shehri
Mohammed A
MA
Pulmonary and Gastroenterology Unit, Department of Pediatrics, College of Medicine, Assir Central Hospital, Kingdom of Saudi Arabia. fariss2000@yahoo.com
Al-Binali
Ali M
AM
Eid
Waleed A
WA
Osinowo
Olu A
OA
Mohammed
Nabil E
NE
D002675:Child, Preschool; D005260:Female; D006548:Hernia, Diaphragmatic / Q000175:diagnosis / Q000601:surgery; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D013270:Stomach / Q000002:abnormalities* / Q000601:surgery; D014102:Torsion Abnormality / Q000151:congenital / Q000175:diagnosis / Q000601:surgery