Department of Radiology and Physical Medicine, School of Medicine, University of Granada, Granada, Spain.
Rev Esp Enferm Dig. 2011 Sep;103(9):484-91. doi: 10.4321/s1130-01082011000900009.
Bochdalek hernias (BHs) are produced in the posterolateral area of the diaphragm. They are generally congenital, appearing in childhood, but are also detected in asymptomatic adult patients seeking medical attention for other reasons. Computed tomography (CT) or magnetic resonance imaging (MRI) is used for the correct diagnosis of the hernia type and for its localization, facilitating its management and the choice of treatment. We describe three cases of Bochdalek hernia, two on the right side and one bilateral, which was larger on the right than left side. All of these hernias contained only omental fat. In one patient, the right kidney was adjacent to the diaphragmatic defect but remained within the abdomen. The patients showed no symptoms and were not surgically treated. Examination by multislice CT with the possibility of coronal and sagittal reconstruction should be considered the standard method for diagnosing this entity. MRI in T1 is highly valuable to evaluate fat-containing chest lesions. The incidental finding of BH in asymptomatic adults is increasing, thanks to the wider application of new imaging techniques.
膈疝(Bochdalek hernias,BHs)发生于膈肌的后外侧。一般为先天性,在儿童时期出现,但也有在无症状成年患者因其他原因就诊时被发现。计算断层扫描(CT)或磁共振成像(MRI)用于正确诊断疝类型及其定位,有助于其管理和治疗选择。我们描述了 3 例 Bochdalek 疝,其中 2 例位于右侧,1 例双侧,右侧大于左侧。这些疝均仅包含网膜脂肪。在 1 例患者中,右肾紧邻膈缺损,但仍位于腹部内。患者无症状,未接受手术治疗。多排 CT 检查,可行冠状位和矢状位重建,应被视为诊断该疾病的标准方法。T1 加权 MRI 对评估含脂肪的胸部病变非常有价值。由于新成像技术的广泛应用,无症状成年患者中 BH 的偶然发现正在增加。