老年患者右侧Bochdalek疝：1982年至2015年日本成人Bochdalek疝病例回顾
Right-sided Bochdalek hernia in an elderly patient: a case review of adult Bochdalek hernias from 1982 to 2015 in Japan.
作者信息
Ohtsuka Yasuhiro, Suzuki Tiberiu H
机构信息
Department of General and Emergency Medicine Funabashi Central Hospital of Japan Community Health Care Organization Funabashi Japan.
Department of Surgery Funabashi Central Hospital of Japan Community Health Care Organization Funabashi Japan.
出版信息
Acute Med Surg. 2016 Nov 10;4(2):209-212. doi: 10.1002/ams2.249. eCollection 2017 Apr.
CASE
An 89-year-old woman was admitted to our hospital because of dyspnea following abdominal pain and vomiting. According to chest computed tomography findings, a diagnosis of acute respiratory failure due to right-sided Bochdalek hernia was made.
OUTCOME
Emergency laparotomy revealed that a bowel loop from the terminal ileum to the transverse colon had herniated into the right thoracic cavity through the foramen of Bochdalek. The herniated organs were reduced to the abdominal cavity and the foramen was repaired by direct suturing. The patient had good recovery and was discharged 78 days later.
CONCLUSION
Bochdalek hernias in elderly patients are rare, but may be complicated by strangulation of the herniated organ. This should be taken into account by acute care physicians. To prevent this fatal complication, regardless of symptoms, surgical treatment may be essential as soon as a diagnosis of adult Bochdalek hernia is made.
病例
一名89岁女性因腹痛和呕吐后出现呼吸困难入住我院。根据胸部计算机断层扫描结果，诊断为右侧博赫dalek疝导致的急性呼吸衰竭。
结果
急诊剖腹手术显示，一段从回肠末端到横结肠的肠袢通过博赫dalek孔疝入右侧胸腔。将疝出的器官回纳至腹腔，并通过直接缝合修复该孔。患者恢复良好，78天后出院。
结论
老年患者的博赫dalek疝罕见，但可能并发疝出器官绞窄。急性护理医生应考虑到这一点。为预防这种致命并发症，一旦诊断为成人博赫dalek疝，无论有无症状，手术治疗可能至关重要。
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