Hamid Kamran S, Rai Surjit S, Rodriguez Joaquin A
Department of Surgery, Scott and White Memorial Hospital, Scott, Sherwood and Brindley Foundation, The Texas A&M University Health Science Center, 2401 South 31st Street, Temple, Texas 76508, USA.
JSLS. 2010 Apr-Jun;14(2):279-81. doi: 10.4293/108680810X12785289144719.
Bochdalek hernias are congenital diaphragmatic defects resulting from the failure of posterolateral diaphragmatic foramina to fuse in utero. Symptomatic Bochdalek hernias in adults are infrequent and may lead to gastrointestinal dysfunction or severe pulmonary disease. We describe our experience with this rare entity.
A retrospective chart review was performed on a single patient for data collection purposes.
The patient is a morbidly obese 53-year-old female who presented with epigastric pain and diffuse abdominal tenderness. Computed tomography scans of the chest and abdomen revealed a small posterior diaphragmatic defect containing gastric fundal diverticulum. Laboratory work and imaging revealed no other findings. Laparoscopic repair of the Bochdalek hernia was done via an abdominal approach and utilized primary closure with an AlloDerm patch apposed to the defect. The patient has had significant clinical improvement and continues to do well at 9 months postoperatively.
Laparoscopic repair of symptomatic adult Bochdalek hernias can be performed successfully and may result in significant clinical improvement.
波氏疝是由于胎儿期后外侧膈肌孔未能融合而导致的先天性膈肌缺损。成人有症状的波氏疝并不常见，可能导致胃肠功能障碍或严重肺部疾病。我们描述了我们对这一罕见病症的治疗经验。
为收集数据，对一名患者进行了回顾性病历审查。
患者为一名53岁病态肥胖女性，表现为上腹部疼痛和全腹压痛。胸部和腹部计算机断层扫描显示膈肌后部有一个小缺损，其中包含胃底憩室。实验室检查和影像学检查未发现其他异常。通过腹部入路对波氏疝进行了腹腔镜修复，采用原位置缝合，并在缺损处贴附了一块异体真皮补片。患者临床症状有显著改善，术后9个月情况仍良好。
有症状的成人波氏疝腹腔镜修复术可成功实施，并可能带来显著的临床改善。
