成人先天性后外侧膈疝：两例病例报告及围手术期心肺并发症综述
Bochdalek hernia in an adult: two case reports and a review of perioperative cardiopulmonary complications.
作者信息
Akita Masayuki, Yamasaki Nobuaki, Miyake Taiichiro, Mimura Kazuya, Maeda Eri, Nishimura Tohru, Abe Koichiro, Kozuki Akihito, Yokoyama Kunio, Kominami Hiroaki, Tanaka Tomohiro, Takamatsu Manabu, Kaneda Kunihiko
机构信息
Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan.
出版信息
Surg Case Rep. 2020 Apr 17;6(1):72. doi: 10.1186/s40792-020-00833-w.
BACKGROUND
Bochdalek hernia in an adult is very rare and often needs an immediate surgical repair for the herniation. Although its etiology and surgical techniques have frequently been reported, perioperative complications, especially cardiopulmonary problems, remain unknown. We reported two adults with Bochdalek hernia and reviewed the published literatures with a focus on these issues.
CASE PRESENTATION
We experienced two adult cases of Bochdalek hernia with gastrointestinal strangulation. One case had massive herniation of the stomach, colon, spleen, and pancreas in the left chest, causing repeated vomiting. The other had a right-side hernia with strangulation of the colon. We successfully performed emergency repairs of these diaphragmatic hernias without any postoperative complications.
CONCLUSIONS
Our literature review revealed that life-threatening cardiopulmonary complications, such as empyema or cardiac arrest caused by the tamponade effect of the herniated viscera, sometimes occurred in patients with Bochdalek hernia. These complications were found in Bochdalek hernia with gastrointestinal strangulation.
背景
成人Bochdalek疝非常罕见，常因疝出而需要立即进行手术修复。尽管其病因和手术技术已有很多报道，但围手术期并发症，尤其是心肺问题，仍不清楚。我们报告了两例成人Bochdalek疝患者，并重点针对这些问题回顾了已发表的文献。
病例报告
我们遇到两例成人Bochdalek疝伴胃肠道绞窄。一例患者左侧胸腔内胃、结肠、脾脏和胰腺大量疝出，导致反复呕吐。另一例为右侧疝伴结肠绞窄。我们成功地对这些膈疝进行了急诊修复，术后无任何并发症。
结论
我们的文献回顾显示，Bochdalek疝患者有时会发生危及生命的心肺并发症，如因疝入脏器的压迫效应导致的脓胸或心脏骤停。这些并发症在伴有胃肠道绞窄的Bochdalek疝中被发现。
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