Banchini Filippo, Santoni Roberta, Banchini Antonio, Bodini Flavio Cesare, Capelli Patrizio
U.O. Chirurgia Generale Vascolare Senologica, Ospedale Guglielmo da Saliceto, Via Taverna 49, cap, 29100 Piacenza, Italy.
Unità di Medicina Legale, Dipartimento di Scienze Biomediche, Biotecnologiche e Traslazionali - S.Bi.Bi.T., Università degli Studi di Parma, Parma, Italy.
Springerplus. 2016 Sep 14;5(1):1561. doi: 10.1186/s40064-016-3221-2. eCollection 2016.
Posterior right diaphragmatic hernia is rare in newborn patients but when present, is accompanied by high mortality. Pulmonary hypoplasia seems to be the main cause of death but the presence of liver involvement remains one of the reasons for poor prognosis even when intrauterine surgery is performed.
In this article, we will present a rare case that was diagnosed by chance in a 65-year old adult presenting with an adenocarcinoma of the rectosigmoid junction and a right Bochdalek hernia with liver herniation and modification of the hepatic vein outflow with a natural right to left shunt.
Diaphragmatic repair was performed on the patient with a mash and simultaneous colorectal resection. Intraoperatively, the exceptional natural modification of the hepatic outflow and alteration of the caval system was evident.
This case report represent an extremely rare anatomic variation and could be useful to give new important information on the evolution that occur in foetal life.
右后膈疝在新生儿患者中较为罕见，但一旦出现，死亡率很高。肺发育不全似乎是主要死因，但即使进行了宫内手术，肝脏受累仍是预后不良的原因之一。
在本文中，我们将呈现一例罕见病例，该病例偶然被诊断出来，患者为一名65岁成年人，患有直肠乙状结肠交界处腺癌以及右侧Bochdalek疝，伴有肝脏疝入以及肝静脉流出道改变并伴有自然的右向左分流。
对该患者进行了补片修补膈肌手术并同时进行了结直肠切除术。术中，肝流出道的特殊自然改变和腔静脉系统的改变很明显。
本病例报告代表了一种极其罕见的解剖变异，可能有助于提供有关胎儿期发生的演变的新的重要信息。
