Acute dyspnoea due to an incarcerated right-sided Bochdalek's hernia.
We present the case of a 76-year-old man with a right-sided Bochdalek hernia, admitted acutely with dyspnoea, abdominal distension and constipation. A chest radiograph and computed tomogram of the abdomen revealed marked elevation of the right hemidiaphragm caused by herniation of the colon. At laparotomy, strangulation of a portion of transverse colon was identified at the site of the foramen of Bochdalek. The contents of the hernia were reduced and a primary repair of the hernial orifice was performed. The segment of necrosed colon was resected and an end-to-end handsewn anastomosis was constructed. A symptomatic Bochdalek hernia typically presents as a cardiorespiratory emergency in the neonatal period. It can remain silent and present in adulthood with chronic gastro-intestinal or respiratory symptoms. Occasionally it presents with acute dyspnoea or abdominal pain. Early detection and intervention is of the utmost importance to decrease related morbidity and mortality in adults.
Kavanagh
D O
DO
Department of Surgery, Mayo General Hospital, Castlebar, Co Mayo, Rochester, USA. dara_kav@hotmail.com
Ryan
R S
RS
Waldron
R
R
D000208:Acute Disease; D000368:Aged; D004417:Dyspnea / Q000209:etiology*; D017809:Fatal Outcome; D006548:Hernia, Diaphragmatic / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D012128:Respiratory Distress Syndrome / Q000209:etiology; D020521:Stroke / Q000209:etiology