title: Right posterior diaphragmatic hernia (Bochdalek) with liver involvement and alteration of hepatic outflow in adult: a case report.
abstract: BACKGROUND
  Posterior right diaphragmatic hernia is rare in newborn patients but when present, is accompanied by high mortality. Pulmonary hypoplasia seems to be the main cause of death but the presence of liver involvement remains one of the reasons for poor prognosis even when intrauterine surgery is performed.
  
  
  METHODS
  In this article, we will present a rare case that was diagnosed by chance in a 65-year old adult presenting with an adenocarcinoma of the rectosigmoid junction and a right Bochdalek hernia with liver herniation and modification of the hepatic vein outflow with a natural right to left shunt.
  
  
  CONCLUSIONS
  Diaphragmatic repair was performed on the patient with a mash and simultaneous colorectal resection. Intraoperatively, the exceptional natural modification of the hepatic outflow and alteration of the caval system was evident.
  
  
  CONCLUSIONS
  This case report represent an extremely rare anatomic variation and could be useful to give new important information on the evolution that occur in foetal life.
authors.affiliation: U.O. Chirurgia Generale Vascolare Senologica, Ospedale Guglielmo da Saliceto, Via Taverna 49, cap, 29100 Piacenza, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Banchini
authors.affiliation: U.O. Chirurgia Generale Vascolare Senologica, Ospedale Guglielmo da Saliceto, Via Taverna 49, cap, 29100 Piacenza, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Santoni
authors.affiliation: Unità di Medicina Legale, Dipartimento di Scienze Biomediche, Biotecnologiche e Traslazionali - S.Bi.Bi.T., Università degli Studi di Parma, Parma, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Banchini
authors.affiliation: U.O. Radiologia, Ospedale Guglielmo da Saliceto, Piacenza, Italy.
authors.forename: Flavio Cesare
authors.initials: FC
authors.lastname: Bodini
authors.affiliation: U.O. Chirurgia Generale Vascolare Senologica, Ospedale Guglielmo da Saliceto, Via Taverna 49, cap, 29100 Piacenza, Italy.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Capelli
keywords: Bochdalek; Hepatic vein; Liver herniation; Right diaphragmatic hernia