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手术治疗嵌顿于胸膜外间隙的博赫达勒克疝:1例罕见病例报告

Surgical treatment of Bochodalek hernia incarcerated into the extra-pleural space: A rare case report.

作者信息

Haro Akira, Kawano Hiroyuki, Hamatsu Takayuki, Suehiro Taketoshi, Koike Makiko, Sugimachi Keizo

机构信息

Department of Chest Surgery, Onga Nakama Medical Association Onga Hospital, Onga-gun, Japan.

Department of Surgery, Onga Nakama Medical Association Onga Hospital, Onga-gun, Japan.

出版信息

Int J Surg Case Rep. 2020;73:179-182. doi: 10.1016/j.ijscr.2020.07.027. Epub 2020 Jul 15.

Abstract

INTRODUCTION

Bochdalek hernias are a type of diaphragm hernia. Almost all occur in the neonatal period, only 5% of these hernias occurring in adults. We here present a rare case of adult Bochdalek hernia incarcerated in the extra-pleural space.

PRESENTATION OF CASE

An asymptomatic 51-year-old man was admitted to our hospital for a detailed examination after an abnormality had been detected on a chest radiograph. Chest computed tomography (CT) examination revealed findings consistent with a left Bochdalek hernia, which we repaied surgically. Intraoperatively, retroperitoneal fatty tissue was found to be incarcerated in the extra-pleural space. Thus, surgical repair required dissection of the parietal pleura and excision of the incarcerated fatty tissues.

DISCUSSION

The incarceration of the Bochdalek hernia in the extra-pleural space could not be identified on a preoperative chest CT examination. To the best of our knowledge, no reports of incarceration of a Bochdalek hernia in the extra-pleural space have been published; thus, this phenomenon is extremely rare.

CONCLUSION

Surgical treatment of a Bochdalek hernia incarcerated in the extra-pleural space requires dissection of the parietal pleura and repair via a transthoracic approach.

摘要

引言

博赫dalek疝是一种膈疝。几乎所有病例都发生在新生儿期,只有5%的此类疝发生在成人身上。我们在此报告一例罕见的成人博赫dalek疝嵌顿于胸膜外间隙的病例。

病例介绍

一名51岁无症状男性因胸部X线片检查发现异常而入院进行详细检查。胸部计算机断层扫描(CT)检查显示结果与左侧博赫dalek疝相符,我们对其进行了手术修复。术中发现腹膜后脂肪组织嵌顿于胸膜外间隙。因此,手术修复需要剥离壁层胸膜并切除嵌顿的脂肪组织。

讨论

术前胸部CT检查未能发现博赫dalek疝嵌顿于胸膜外间隙的情况。据我们所知,尚未有关于博赫dalek疝嵌顿于胸膜外间隙的报道;因此,这种现象极为罕见。

结论

对于嵌顿于胸膜外间隙的博赫dalek疝,手术治疗需要剥离壁层胸膜并通过经胸入路进行修复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc5f/7378314/b5a6aa3aba2a/gr1.jpg

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