Waters James P, Topper Gena V, Romiyo Vineeth, Hayden Ian P, Panico Robert A, Shersher David D
Cooper Medical School of Rowan University, 401 Broadway, Camden, NJ 08103, United States.
Cooper University Hospital Department of General Surgery, 1 Cooper Plaza, Camden NJ 08103, United States.
J Surg Case Rep. 2025 Jan 30;2025(1):rjae696. doi: 10.1093/jscr/rjae696. eCollection 2025 Jan.
Bochdalek hernias arise from a developmental failure of the pleuroperitoneal canal to close, allowing abdominal contents to herniate into the thorax and compress the developing lung parenchyma. In rare cases, Bochdalek hernias may arise in adults and usually present with symptoms related to the hernia. Treatment consists of either open, laparoscopic, or robotic repair to close the defect. We present an unusual case in which an elderly patient presented with a large left-sided Bochdalek hernia containing both an incarcerated stomach and spleen following an uncomplicated robotic left nephrectomy. The hernia was successfully reduced and reconstructed with mesh via open abdominal repair with minimal complications. Repairing these hernias is challenging and, as in this case, required a complex reconstruction of diaphragm with mesh attachment to the ribs. Further reports on acute management of iatrogenic Bochdalek hernias in adults are warranted to better understand long-term post-operative outcomes and optimize management.
博赫dalek疝源于胸膜腹膜管发育性闭合失败，使腹腔内容物疝入胸腔并压迫发育中的肺实质。在罕见情况下，博赫dalek疝可发生于成人，通常表现为与疝相关的症状。治疗方法包括开放手术、腹腔镜手术或机器人手术修复以闭合缺损。我们报告一例不寻常病例，一名老年患者在进行无并发症的机器人辅助左肾切除术后，出现巨大左侧博赫dalek疝，疝内容物包括嵌顿的胃和脾脏。通过开放腹部修复成功将疝还纳并用补片重建，并发症极少。修复这些疝具有挑战性，如本病例所示，需要用补片附着于肋骨对膈肌进行复杂重建。有必要进一步报道成人医源性博赫dalek疝的急性处理情况，以更好地了解长期术后结果并优化管理。
