Yao Zuhuan, Huang Ai, Wan Li, Hu Shaobo, Nie Jun, Jiang Ke
Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, China.
Liver Transplant Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, China.
J Surg Case Rep. 2025 Mar 28;2025(4):rjaf027. doi: 10.1093/jscr/rjaf027. eCollection 2025 Apr.
Bochdalek hernia is a congenital diaphragmatic hernia typically arising from developmental defects in the diaphragm, allowing abdominal organs to protrude into the thoracic cavity. It primarily affects neonates, with adult cases being rare. This report presents a 19-year-old male with a right-sided Bochdalek hernia containing the liver, gallbladder, and colon, causing compression of the right lung and mediastinum, resulting in respiratory distress. CT imaging illustrated the extent of the herniated organs and their impact on thoracic structures. A combined abdominal and thoracic approach was utilized, including adhesiolysis, reduction of herniated organs, and repair of the diaphragmatic defect with a composite mesh. Postoperatively, the patient showed significant respiratory improvement and experienced a favorable recovery. This case underscores the need to consider Bochdalek hernia in adults with unexplained respiratory distress and abnormal imaging findings.
博赫dalek疝是一种先天性膈疝，通常源于膈肌发育缺陷，使腹腔器官突入胸腔。它主要影响新生儿，成人病例罕见。本报告介绍了一名19岁男性，患有右侧博赫dalek疝，疝内容物包括肝脏、胆囊和结肠，导致右肺和纵隔受压，引起呼吸窘迫。CT成像显示了疝出器官的范围及其对胸部结构的影响。采用了腹部和胸部联合入路，包括粘连松解、疝出器官还纳以及用复合补片修复膈肌缺损。术后，患者呼吸明显改善，恢复良好。该病例强调，对于有不明原因呼吸窘迫和异常影像学表现的成人，需要考虑博赫dalek疝。
