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成人Bochdalek疝伴胃扭转:初始诊断的常见症状

Bochdalek Hernia With Gastric Volvulus in an Adult: Common Symptoms for an Original Diagnosis.

作者信息

Atef Mejri, Emna Trigui

机构信息

From the Department of Surgery, Hospital of Jendouba, Jendouba, Tunisia.

出版信息

Medicine (Baltimore). 2015 Dec;94(51):e2197. doi: 10.1097/MD.0000000000002197.

Abstract

Bochdalek hernias in adulthood are rare. Symptomatic Bochdalek hernias in adults are rarer, but may lead to fatal complications. Patients with acute gastric volvulus on diaphragmatic hernia are a diagnostic and therapeutic emergency.Here, we report a case of a 56-year-old woman diagnosed with epigastric pain, cough, vomiting since 2 weeks and shortness of breath. Complicated Bochdalek hernia was an incidental finding, diagnosed by chest radiograph, computed tomography (CT), and barium swallow study. Stomach was within the thorax in the left side due to left diaphragmatic hernia of a nontraumatic cause.The patient was prepared for the laparoscopic surgical repair, to close the defect. The patient recovered with accepted general condition and was discharged 9 days later.Diagnoses of Bochdalek hernias in adulthood are challenging. However, although rare, this possibility should be kept in mind to avoid fatal complications.

摘要

成人期的博赫dalek疝很罕见。成人有症状的博赫dalek疝更为罕见,但可能导致致命并发症。患有膈疝合并急性胃扭转的患者是诊断和治疗的急症。在此,我们报告一例56岁女性病例,该患者自2周前出现上腹部疼痛、咳嗽、呕吐及呼吸急促。复杂的博赫dalek疝是偶然发现的,通过胸部X线、计算机断层扫描(CT)和吞钡造影检查确诊。由于非创伤性原因导致左侧膈疝,胃位于胸腔左侧。患者接受了腹腔镜手术修复准备,以闭合缺损。患者恢复良好,一般状况可,9天后出院。诊断成人期的博赫dalek疝具有挑战性。然而,尽管罕见,但应牢记这种可能性以避免致命并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00cb/4697971/eabd389b52ab/medi-94-e2197-g001.jpg

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