Strangulated Bochdalek Hernia: Approach of Management in Emergency Setting

Authors

  • Pradeep Chand Chandran 1Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia. 2Department of Surgery, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia.
  • Dinesh Baithma Jothi 2Department of Surgery, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia. 3Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • Firdaus Hayati
  • Chiak Yot Ng Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia

Abstract

Bochdalek hernia is a type of congenital diaphragmatic hernia that primarily manifests in children however in rare instances they do manifest in adulthood spontaneously or after physical exertion. We report a case of a left-sided Bochdalek hernia in an adult who presented with left-sided chest pain and worsening symptoms of dyspnea. His chest radiograph revealed dilated small bowel loops in the left hemithorax causing a mediastinal shift. A computed tomography done revealed a posterolateral diaphragmatic defect through which the abdominal viscera had herniated. He was subsequently intubated due to severe respiratory distress. The patient underwent an emergency laparotomy which revealed a large 10 cm posterolateral diaphragmatic defect with herniation of small bowel, spleen and transverse colon. The small bowel was gangrenous and perforated therefore a primary repair of the defect with non-absorbable sutures was done. Gangrenous bowel was resected and primary anastomosis was done. Postoperatively, the patient had significant clinical improvement and was discharged a week later with no immediate complications.

Author Biographies

Pradeep Chand Chandran, 1Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia. 2Department of Surgery, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia.

1Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.

2Department of Surgery, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia.

Dinesh Baithma Jothi, 2Department of Surgery, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia. 3Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

2Department of Surgery, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia.

3Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

Chiak Yot Ng, Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia

Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia

Downloads

Published

25.06.2021

Most read articles by the same author(s)

1 2 3 > >>