title: Right-sided Bochdalek hernia obstructing in an adult: case report and review of the literature.
abstract: Bochdalek hernias on the right side of the diaphragm are very rarely diagnosed in adults. We review a case of a 35-year-old female who presented acutely with intestinal obstruction. Plain and cross-sectional imaging identified a large right-sided Bochdalek hernia, containing colon, causing a mechanical obstruction and, surprisingly, concurrent appendicitis. The patient underwent an emergency laparotomy. At surgery the colon was reduced and was viable. The diaphragmatic defect was repaired using non-absorbable sutures and an appendicectomy was then performed for purulent appendicitis. She made an uneventful recovery and remains well at 9-month follow-up. We discuss what we believe to be the first reported case of an obstructed right-sided Bochdalek's hernia associated with appendicitis in an adult and review the published literature on this rare condition.
authors.affiliation: Department of Surgery, St. James University Hospital, Leeds, UK.
authors.forename: S
authors.initials: S
authors.lastname: Rout
authors.forename: F J
authors.initials: FJ
authors.lastname: Foo
authors.forename: J D
authors.initials: JD
authors.lastname: Hayden
authors.forename: A
authors.initials: A
authors.lastname: Guthrie
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Smith
mesh_terms: D000328:Adult; D044684:Colon, Transverse; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006548:Hernia, Diaphragmatic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D007813:Laparotomy / Q000379:methods*; D012720:Severity of Illness Index; D013536:Suture Techniques; D014057:Tomography, X-Ray Computed