John Pravin Hector, Thanakumar John, Krishnan Arunkumar
Minimal Access, Bariatric and GI Surgery, Global Hospitals and Health City, Chennai, India.
J Minim Access Surg. 2012 Oct;8(4):158-60. doi: 10.4103/0972-9941.103131.
Bochdalek hernia is a congenital defect of the diaphragm that usually presents in the neonatal period with life-threatening cardiorespiratory distress. It is rare for Bochdalek hernias to remain silent until adulthood. A 57-year-old woman presented with history of difficulty in swallowing, as well as retching. There was no history of abdominal or thoracic trauma. A chest x-ray showed the herniated stomach clearly. Computed tomography (CT) of the abdomen showed a herniated volvulus of the stomach, along with left posterolateral diaphragmatic hernia. The defect was repaired by a single incision laparoscopic technique. We present the first case of a posterolateral diaphragmatic hernia repaired by a reduced port laparoscopic technique in an adult, after an extensive literature search yielded no precedents. This report validates the feasibility of reduced port laparoscopic repair of Bochdalek hernia in an adult, and should be within the remit of the advanced laparoscopic surgeon.
博赫dalek疝是一种先天性膈肌缺陷，通常在新生儿期出现危及生命的心肺窘迫。博赫dalek疝在成年前一直无症状的情况很少见。一名57岁女性因吞咽困难和干呕前来就诊。无腹部或胸部外伤史。胸部X光片清晰显示疝入的胃。腹部计算机断层扫描（CT）显示胃扭转疝，伴有左后外侧膈肌疝。通过单切口腹腔镜技术修复了缺损。在广泛查阅文献未发现先例后，我们报告了首例采用减少端口腹腔镜技术修复成人后外侧膈肌疝的病例。本报告证实了减少端口腹腔镜修复成人博赫dalek疝的可行性，这应该属于高级腹腔镜外科医生的职责范围。
