Rout S, Foo F J, Hayden J D, Guthrie A, Smith Andrew M
Department of Surgery, St. James University Hospital, Leeds, UK.
Hernia. 2007 Aug;11(4):359-62. doi: 10.1007/s10029-007-0188-5. Epub 2007 Mar 7.
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.
成人右侧膈肌Bochdalek疝很少被诊断出来。我们回顾了一例35岁急性肠梗阻女性病例。平片和断层成像显示一个巨大的右侧Bochdalek疝，疝内容物为结肠，导致机械性肠梗阻，令人惊讶的是，同时并发阑尾炎。患者接受了急诊剖腹手术。术中结肠回纳且血运良好。使用不可吸收缝线修复膈肌缺损，然后对化脓性阑尾炎进行阑尾切除术。她恢复顺利，9个月随访时情况良好。我们讨论了我们认为是首例报道的成人右侧梗阻性Bochdalek疝合并阑尾炎的病例，并回顾了关于这种罕见疾病的已发表文献。
