Yetkinel Selçuk, Pekşen Çağhan, Kızıltan Remzi
Department of Gynecology and Obstetrics, Agri State Hospital, 04000 Ağrı, Turkey.
Department of Surgery, School of Medicine, Van Yüzüncü Yıl University, 65090 Van, Turkey.
Case Rep Surg. 2017;2017:2862149. doi: 10.1155/2017/2862149. Epub 2017 Oct 16.
Symptomatic Bochdalek hernia in pregnancy is quite rare. To the best of our knowledge, there are a total of 44 cases reported in the literature between 1959 and 2016 (Hernández-Aragon et al., 2015; Koca et al., 2016). Difficulty and delay in diagnosis may lead to life-threatening complications.
We report a case of Bochdalek hernia during the 30 gestational weeks' pregnancy in whom pregnancy continued after surgical repair which resulted in term birth.
Bochdalek hernia is diagnosed with an incidence of 1 in 2200-12500 live births, while symptomatic diaphragm hernia is much less in adults. The actual incidence of diaphragmatic hernias during pregnancy is still unknown. Symptoms may include abdominal distension, recurrent abdominal pain, nausea, vomiting, inability to defecate, dyspnea, and chest pain. The patient with diaphragmatic hernia may be asymptomatic until the late weeks of gestation, as in our case, or herniation may occur during advanced gestational weeks with increased intraabdominal pressure.
In conclusion, diagnosis of the diaphragm hernia during pregnancy is very rare. Diagnosis is rarer in symptomatic patients due to its rarity and the duration of diagnosis may, therefore, be delayed. Diaphragm hernia should be kept in mind in symptomatic patients due to its high maternal and fetal mortality rates.
妊娠期有症状的博赫dalek疝相当罕见。据我们所知,1959年至2016年期间文献中总共报道了44例(埃尔南德斯 - 阿拉贡等人,2015年;科卡等人,2016年)。诊断困难和延迟可能导致危及生命的并发症。
我们报告一例妊娠30周时发生博赫dalek疝的病例,该患者在手术修复后继续妊娠并足月分娩。
博赫dalek疝在活产中的发病率为1/2200 - 12500,而有症状的膈疝在成人中则少得多。妊娠期膈疝的实际发病率仍然未知。症状可能包括腹胀、反复腹痛、恶心、呕吐、无法排便、呼吸困难和胸痛。膈疝患者可能直到妊娠晚期都没有症状,就像我们的病例一样,或者在妊娠晚期随着腹内压升高而发生疝出。
总之,妊娠期膈疝的诊断非常罕见。由于其罕见性,有症状患者的诊断更为罕见,因此诊断时间可能会延迟。鉴于其高母婴死亡率,有症状的患者应考虑膈疝。