Bochdalek Hernia
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Right-Sided Giant Bochdalek Hernia in an Adult: a Case Report Saana Andersson*, Juha Kauppi and Jari Räsänen
SURGICAL CASE REPORTS | ISSN 2613-5965 Available online at www.sciencerepository.org Science Repository Case Report Right-sided Giant Bochdalek hernia in an adult: a case report Saana Andersson*, Juha Kauppi and Jari Räsänen Department of General Thoracic and Esophageal Surgery, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland A R T I C L E I N F O A B S T R A C T Article history: Diagnosis of a Bochdalek hernia in an adult is rare and even more so in the right diaphragm. Received: 29 April, 2019 We review a case of a 55-year-old woman with a right-sided giant Bochdalek hernia who was experiencing Accepted: 11 June, 2019 progressive shortness of breath and performance decline. The diagnosis of Bochdalek hernia was made by Published: 30 August, 2019 computed tomography and the right side of liver, right kidney, omentum and flexura hepatica of the colon Keywords: were herniated to the right hemithorax. The operation was carried out via right thoraco-laparotomy and she Adult made an uneventful recovery. We conclude that maximal exposure was necessary for safe operation and bochdalek good outcome. right sided © 2019 Saana Andersson Hosting by Science Repository. All rights reserved. Introduction thorax (Figure 1). Our patient underwent an elective operation and initially thoracotomy was performed. The right lobe of liver, flexura Bochdalek hernia is a diaphragmatic hernia usually diagnosed during the hepatica of the colon, omentum and right kidney were herniated into the neonatal period. It typically occurs in the left hemi-diaphragm and right hemithorax. The diaphragm was missing posteriorly and laterally, presents with severe respiratory and circulatory compromise. -
Appendix 3.1 Birth Defects Descriptions for NBDPN Core, Recommended, and Extended Conditions Updated March 2017
Appendix 3.1 Birth Defects Descriptions for NBDPN Core, Recommended, and Extended Conditions Updated March 2017 Participating members of the Birth Defects Definitions Group: Lorenzo Botto (UT) John Carey (UT) Cynthia Cassell (CDC) Tiffany Colarusso (CDC) Janet Cragan (CDC) Marcia Feldkamp (UT) Jamie Frias (CDC) Angela Lin (MA) Cara Mai (CDC) Richard Olney (CDC) Carol Stanton (CO) Csaba Siffel (GA) Table of Contents LIST OF BIRTH DEFECTS ................................................................................................................................................. I DETAILED DESCRIPTIONS OF BIRTH DEFECTS ...................................................................................................... 1 FORMAT FOR BIRTH DEFECT DESCRIPTIONS ................................................................................................................................. 1 CENTRAL NERVOUS SYSTEM ....................................................................................................................................... 2 ANENCEPHALY ........................................................................................................................................................................ 2 ENCEPHALOCELE ..................................................................................................................................................................... 3 HOLOPROSENCEPHALY............................................................................................................................................................. -
Congenital Defects of the Anterior Abdominal Wall and Diaphragm
Bulletin of the Transilvania University of Braşov Series VI: Medical Sciences • Vol. 10 (59) No. 2 - 2017 CONGENITAL DEFECTS OF THE ANTERIOR ABDOMINAL WALL AND DIAPHRAGM C.A. ARVĂTESCU1 O.G. DIMIENESCU1* S. CASAP1 1 1 1 C. PODAŞCĂ C. COBELSCHI A. MIRONESCU Abstract: Congenital defects of the anterior abdominal wall and diaphragm are malformations occurring during embryogenesis and include gastroschisis, omphalocele and diaphragmatic hernia. Diaphragmatic hernia is often accompanied by pulmonary hypoplasia that causes fetal asphyxia with varying degrees of severity. The purpose of this study was to evaluate the prevalence of congenital malformations of the anterior abdominal wall and diaphragm in the Clinical Hospital of Obstetrics and Gynecology Brasov between the years 2011 and 2017. The 29 cases included in the study range in severity from minor malformations, easily corrected through surgical procedures to severe malformations associated with other congenital anomalies that are incompatible with life. The most common congenital defect encountered in our study is diaphragmatic hernia, which can be diagnosed through correct follow up of the pregnancy, monthly ultrasounds and screening tests. Key words: omphalocele, gastroschisis, diaphragmatic hernia, abdominal wall defect. 1. Introduction but the commonest form of congenital diaphragmatic hernia is the classic Congenital defects of the anterior posterolateral or Bochdalek hernia [5]. abdominal wall and diaphragm are Omphalocele is a large defect of the malformations occurring during abdominal wall, in which the viscera embryogenesis. Omphalocele and coming out of the abdomen always has a gastroschisis are the most frequent defects sac and occurs because the rectus muscles of the anterior abdominal wall, with a are inserted laterally on the costal margins. -
An Elderly Patient with Bochdalek's Hernia Case That Implies Left-Sided
Case Report Eur J Gen Med 2012;9(1):64-66 An Elderly Patient with Bochdalek’s Hernia Case that Implies Left-Sided Intratoracic Renal Ectopia Hakan Önder1, Şükran Güler1, Güven Tekbaş1, Ayla Büyükkaya2, Hatice Gümüş1, Faysal Ekici1, Akın Önder3, Aslan Bilici1 ABSTRACT Bochdalek hernia is a congenital disease characterized by protrusion of the abdominal organs into the thorax through the poste- rior defect in the diaphragma. The detection of incidental bochdalek hernia has increased because of the widespread use of the multidedector computed tomography. It is very rare in adult population. Intrathoracic kidney in bochdalek hernia is uncommon. In this paper, a 78 year-old man who had bochdalek hernia with a kidney in the left side of the thoracic region is presented. Key words: Bochdalek hernia , intrathoracic kidney , diaphragmatic hernia Yaşlı Bir Hastada İntratorasik Ektopik Böbrek İle Seyreden Bochdalek Hernisi ÖZET Bochdalek hernisi posterior diafragmadan abdominal organların toraks içerisine yer değiştirmesi ile karakterize konjenital bir hastalıktır.Bochdalek hernisinin insidental olarak tesbiti çok kesitli bilgisayarlı tomografinin(ÇKBT) yaygın kullanılmasıyla artmıştır.Bochdalek hernisi yaşlı kişilerde oldukça nadir görülmektedir. Herni içerisinde böbrek görülmesi de yaygın değildir.Bu yazıda toraksda solda, içerisinde sol böbrek ve kalın barsak ansları bulunan 78 yaşında bir olgu sunulmuştur. Anahtar kelimeler: Bochdalek hernisi, İntratorasik böbrek, diyafragma hernisi INTRODUCTION CASE A Bochdalek hernia occurs when abdominal contents A 78 year-old man referred to our clinics for ultraso- herniated through the posterolateral segment of the dia- nographic examination complaints of abdominal pain phragm (1). Bochdalek hernia is a type of congenital dia- and shortness of breath. The ultrasound examination phragmatic hernia that typically occurs in childhood, but revealed that left kidney was not in its usual location. -
Diaphragmatic Hernia Handout.Indd
Diaphragmatic Hernia A diaphragmatic hernia is a birth defect, which means it occurs before birth as a fetus is forming in the mother’s uterus. The diaphragm has an abnormal opening, and with this type of birth defect, some of the organs that are normally found in the abdomen move up into the chest cavity through this opening. There are two types of diaphragmatic hernia: • Bochdalek hernia. A Bochdalek hernia usually involves an opening on the left side of the dia- phragm. The stomach, liver, spleen and/or intestines usually move up into the chest cavity. • Morgagni hernia. A Morgagni hernia involves an opening in the middle of the diaphragm close to the front of the chest. What causes a diaphragmatic hernia? As a fetus is growing in its mother’s uterus before birth, different organ systems are developing and maturing. The diaphragm develops between the seventh and twelfth weeks of pregnancy. The esophagus (the tube that leads from the throat to the stomach), the stomach and the intestines are also developing at this time. In a Bochdalek hernia, the diaphragm may not develop properly, or the intestine may become trapped in the chest cavity as the diaphragm is forming. In a Morgagni hernia, the tendon that should develop in the middle of the diaphragm does not develop properly. In both cases, normal development of the diaphragm and the digestive tract does not occur. Left-sided Bochdalek hernias make up about 80 to 90 percent of all cases. Morgagni hernias are much less common. Why is a diaphragmatic hernia of concern? The lungs are developing at the same time as the diaphragm and the digestive system. -
Bochdalek Diaphragmatic Hernia: Not Only a Neonatal Disease M Mei-Zahav, M Solomon, D Trachsel, J C Langer
532 ORIGINAL ARTICLE Arch Dis Child: first published as 10.1136/adc.88.6.532 on 1 June 2003. Downloaded from Bochdalek diaphragmatic hernia: not only a neonatal disease M Mei-Zahav, M Solomon, D Trachsel, J C Langer ............................................................................................................................. Arch Dis Child 2003;88:532–535 Aims: To characterise the clinical manifestations of late presenting Bochdalek diaphragmatic hernia (DH), the incidence of misdiagnosis, and prognosis; and to explore the sequence of events that leads to this clinical picture. Methods: Retrospective chart review. All children with Bochdalek DH were identified. Children 1 month of age and older at the time of diagnosis were included. Results: Twenty two children with Bochdalek DH met the inclusion criteria. Three clinical presentations See end of article for could be defined. Fourteen children presented with acute onset of symptoms, predominantly vomiting authors’ affiliations and respiratory distress. Four had chronic non-specific gastrointestinal or respiratory symptoms, and in ....................... four the DH was found incidentally. Although five children were initially misdiagnosed, in 20 children Correspondence to: (91%) the correct diagnosis was made on x ray examination. One child experienced a complicated Dr J C Langer, Chief, course when the x ray picture was misinterpreted as pneumothorax. All children had favourable out- Division of General come. Two children had previously normal chest imaging, suggesting acquired herniation. A large Surgery, Room 1526, pleural effusion without DH in a 9.5 year old girl with an abdominal infection prior to presenting with Hospital for Sick Children, herniation suggests a pre-existing defect in the diaphragm. 555 University Avenue, Toronto, Ontario, M5G Conclusions: Late presenting Bochdalek DH can present with acute or chronic gastrointestinal, or less 1X8, Canada; frequently, respiratory symptoms. -
Bochdalek Hernia Evaluated As Sudden Unexpected Suspicious Death: a Case Report
ADLİ TIP DERGİSİ Journal of Forensic Medicine 1 Adli Tıp Dergisi 2006; 20(1): 35-38 BOCHDALEK HERNIA EVALUATED AS SUDDEN UNEXPECTED SUSPICIOUS DEATH: A CASE REPORT Yrd. Doç. Dr. Ahmet HİLAL1, Yrd. Doç. Dr. Nursel GAMSIZ BİLGİN2, Prof. Dr. Necmi ÇEKİN1, Prof. Dr. Mete K. GÜLMEN1 1 Çukurova Üniversitesi Tıp Fakültesi Adli Tıp Anabilim Dalı, Adana 2 Mersin Üniversitesi Tıp Fakültesi Adli Tıp Anabilim Dalı, Mersin Summary A considerable part of forensic medicine cases involve sudden unexpected suspicious deaths. In such cases, it is essential to perform a medico-legal autopsy, for the following reasons: death occurs within a very short time, it is difficult to explain the cause and the mechanism of death; external factors or a person, might be involved in the death. Sudden unexpected deaths due to adult Bochdalek hernia had been reported rarely in the medical literature. In this study a sudden unexpected death case due to adult Bochdalek hernia was presented. Key Words: Bochdalek hernia, Forensic autopsy, Sudden unexpected death. ANI BEKLENMEDIK ŞÜPHELI ÖLÜM OLARAK DEĞERLENDIRILEN BOCHDALEK HERNISI: BIR OLGU SUNUMU Özet Ani beklenmedik şüpheli ölümler adli olguların önemli bir bölümünü oluşturmaktadır. Bu olgularda ölümün kısa sürede meydana gelmesi, ölüm mekanizmasının ve nedeninin izah edilememesi, ölüm üzerine etkisi olan kişi ve/veya kişilerin ya da her hangi bir dış etmenin olabileceği şüphesi nedeniyle adli otopsi yapılması gerekmektedir. Çalışmamızda Bochdalek hernisine bağlı ani beklenmedik bir ölüm olgusu sunulmaktadır. Anahtar Kelimeler: Bochdalek hernia, Adli otopsi, Ani beklenmedik şüpheli ölüm. Introduction A considerable part of forensic medicine cases involve sudden unexpected suspicious deaths. In such cases, it is essential to perform a medico-legal autopsy, for the following reasons: death occurs within a very short time, it is difficult to explain the cause and the mechanism of death; external factors or a person, might be involved in the death. -
The Abdominal Wall
The Abdominal Wall Normal Anatomy of the Abdominal Gastroschisis/ 224 Wall/ 209 Body Stalk Anomaly/ 226 Diaphragmatic Hernia/ 211 Bladder Exstrophy and Cloacal Omphalocele/ 220 Exstrophy/ 228 Normal Anatomy of the Abdominal Wall The superior wall of the abdominal cavity is formed by the diaphragm. This muscle can be seen as a hipoechogenic line separating the lung and fetal liver (Fig. 6-1). In cases of severe hydrops, the structure appears as a hyperechogenic sheet between the pleural effusion and the ascites. When a massive Pleural effusion is present, the muscle can be inverted. The floor of the abdominal cavity is formed by the pelvic diaphragm. The pelvic bones (iliac crests, ischial ossification centers) and pelvic muscles can be imaged with ultrasound but have limited diagnostic interest (Fig. 6-2). The anterior abdominal wall is formed by the skin, subcutaneous tissue, and muscles. The muscles are visible as hypoechogenic structures (Fig. 6-3). In the past, the image of the muscles has been confused with ascites and referred to as "pseudoascites."1,2 The entrance of the umbilical cord into the fetal abdomen should always be imaged to screen for the presence of an omphalocele (Fig. 6-4). Examination of the anterior abdominal wall should include visualization of its infraumbilical portion in order to rule out caudal fold defects (e.g., bladder exstrophy). Figure 6-5 shows the Figure 6-1. Coronal section of a third trimester fetus. The normal contours of the lower portion of the anterior diaphragm appears as a hypoechogenic line between the thorax and the abdomen. -
A Rare Clinical Entity of Asymptomatic Adult Bochdalek Hernia
International Surgery Journal Ramachandran B et al. Int Surg J. 2020 Oct;7(10):3479-3482 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 DOI: http://dx.doi.org/10.18203/2349-2902.isj20204162 Case Report A rare clinical entity of asymptomatic adult bochdalek hernia Balamurugan Ramachandran1, Aravindan Srinivasan Pugazhenthi1, Abhinav Bharadwaj Rajkumar1*, Saumitra Dube1, Moorthy Perumal2 1Department of General Surgery, SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India 2Department of Cardio Thoracic and Vascular Surgery, SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India Received: 21 July 2020 Revised: 06 September 2020 Accepted: 09 September 2020 *Correspondence: Dr. Aravindan Srinivasan Pugazhenthi, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Bochdalek hernia (BH) is the commonest congenital diaphragmatic hernia, caused by the failure of the posterolateral diaphragmatic foramina to fuse properly. It is extremely rare in adults and accounts for 5-10%. Presenting a case of 48 years female with complaints of dry cough and left chest pain for 1 week. Diminished breath sounds and abnormal gurgling sounds heard on auscultation of left chest wall. X-ray chest showed elevated left hemi diaphragm and gastric bubble. Computed tomography (CT) chest revealed left diaphragmatic hernia with splenic flexure, transverse colon, mesocolon, spleen and upper pole of left kidney as content and atelectasis of left lung lower lobe. -
Management and Complications of a Late-Presenting Congenital Diaphragmatic Hernia
Quill & Scope Volume 9 Volume IX Article 6 2017 Management and Complications of a Late-Presenting Congenital Diaphragmatic Hernia Gabrielle Hatton New York Medical College Nicholas Bartell New York Medical College Follow this and additional works at: https://touroscholar.touro.edu/quill_and_scope Part of the Arts and Humanities Commons, Higher Education Commons, and the Medicine and Health Sciences Commons Recommended Citation Hatton, G., & Bartell, N. (2017). Management and Complications of a Late-Presenting Congenital Diaphragmatic Hernia. Quill & Scope, 9 (1). Retrieved from This Review is brought to you for free and open access by the Students at Touro Scholar. It has been accepted for inclusion in Quill & Scope by an authorized editor of Touro Scholar. For more information, please contact [email protected]. Perspectives Management and Complications of a Late-Presenting Congenital Diaphragmatic Hernia Gabrielle Hatton and Nicholas Bartell A Bochdalek hernia, otherwise known as a congenital dia heart or pulmonary failure. In these cases, postoperative phragmatic hernia (CDH), is a congenital defect resulting follow up is even more important as effects on the pulmo from the failure of the posterolateral diaphragmatic folds nary vasculature can persist even after the hernia has been to fuse in utero. The incidence has been reported as high repaired. These cases illustrate why diaphragmatic hernia as 1 in 2000, with many cases being diagnosed in utero in should be included in the differential diagnosis for pulmo the United States (1). Patients not diagnosed during the nary hypertension. prenatal period typically present with life-threatening car diorespiratory distress soon after birth. Rarely, patients can In a case reviewed by Dobarro and colleagues, an 82 year old woman presented with an 85% oxygen saturation with remain undiagnosed until adulthood. -
A Rare Case of Bochdalek Diaphragmatic Hernia with Concomitant Partial Situs Inversus
International Journal of Research in Medical Sciences Jain R et al. Int J Res Med Sci. 2015 Feb;3(2):494-497 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 DOI: 10.5455/2320-6012.ijrms20150222 Case Report A rare case of Bochdalek diaphragmatic hernia with concomitant partial situs inversus Rishabh Jain1, Ajay Gujar1, Naseem Khan1, Lokesh Sreedharan1, Tanveer Parvez Shaikh1*, Roshan Palresha2, Chaitanya Burra1 1Department of Surgery, Dr. D Y Patil College of Medicine, Nerul, Navi Mumbai, Maharashtra, India 2Department of Emergency Medicine, Dr. D Y Patil College of Medicine, Nerul, Navi Mumbai, Maharashtra, India Received: 19 December 2014 Accepted: 12 January 2015 *Correspondence: Dr. Tanveer Parvez Shaikh, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Congenital diaphragmatic hernias clinically presenting in adulthood are exceedingly rare lesions, mainly left-sided defect (Bochdalek). Bochdalek hernias most commonly manifest during the patient’s first few weeks of life. Diagnosis beyond the first 8 weeks of life is estimated to represent 5-25% of all Bochdalek hernias. Here we have a 32 year old female patient who presented with 10x10 cm diaphragmatic hernia with dextrocardia who was asymptomatic for years. Keywords: Congenital diaphragmatic hernias, Bochdalek hernia, Morgagni hernia INTRODUCTION The three basic types of congenital diaphragmatic hernia include Bochdalek Hernia (BH), anterior Morgagni The topic of Congenital Diaphragmatic Hernia (CDH) Hernia (MH) and hiatus hernia. -
Congenital Diaphragmatic Hernia: Atypical Early X-Ray Presentation
July- August, 2014/ Vol 2/ Issue 4 ISSN 2321-127X Case Report Congenital Diaphragmatic Hernia: Atypical Early X-Ray Presentation Wasey WA1, Srivastava SK2 1Dr Waiz A Wasey, MBBS, 2Shashank Kumar Srivastava, MBBS student, Final part II. Both are affiliated to Shadan Institute of Medical Sciences, Teaching Hospital and Research Centre, Himayath Sagar Road, Hyderabad, Telangana, India. Correspondence Address: Dr Shashank Kumar Shrivastava, E-mail: [email protected]. .................................................................................................................................................................................................... Abstract Congenital Diaphragmatic Hernia (CDH) is a congenital malformation of the diaphragm that allows herniation of the abdominal organs into the thoracic cavity. The most common type of CDH is Bochdalek Hernia. It is seen commonly on the left side than right, the right side being protected by the liver. CDH is a life threatening condition, most likely due to pulmonary hypoplasia. We report a left sided Bochdalek Hernia in a preterm female newborn delivered by Caesarian section. Keywords: Congenital Diaphragmatic Hernia, Bochdalek Hernia, Pulmonary Hypoplasia .................................................................................................................................................................................................... Introduction The incidence of Congenital diaphragmatic hernia is 1 in Her Initial chest x-ray taken, showed a picture