• Journal of Chest Surgery
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• v.26 no.5
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• pp.417-421
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• 1993

Congenital diaphragmatic hernia through Bochdalek foramen, posterolateral diaphragmatic hernia, is the result of a congenital malformation of the posterolateral region of the diaphragm. Bochdalek hernia is the most common type of congenital diaphragmatic hernia, but it is a extremely rare anomaly which is detected in adulthood because it has severe cardiopulmonary and gastrointestinal symptoms after birth immediately.We experienced two cases of Bochdalek hernia which were detected in adulthood. Among them, one was a 43 years old man who was treated with simple closure in left Bochdalek hernia and the other was 41 years old woman who was treated with patch closure using silastic sheet in right Bochdalek hernia. Their postoperative courses were uneventiful. So we report two cases of rare Bochdalek hernia which was detected in adulthood with review of literatures.

• Journal of Chest Surgery
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• v.45 no.5
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• pp.348-350
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• 2012

We herein report a very rare case of adult right-sided Bochdalek hernia accompanied with hepatic hypoplasia and inguinal hernia. A 29-year-old man was admitted with right-sided pneumothorax. A computed tomography was performed and revealed large right sided Bochdalek hernia with hepatic hypoplasia. Under thoracolaparotomy, the defect was closed with Gore-Tex soft tissue patch. After the operation, left-sided inguinal hernia was found. However, it turned out that it had been present during infancy and spontaneously resolved during adolescence. This is the first report of right-sided Bochdalek hernia with hepatic hypoplasia and inguinal hernia in an adult.

• Journal of Chest Surgery
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• v.6 no.1
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• pp.109-112
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• 1973

Bochdalek hernia is the most common congenital diaphragmatic hernia and that of the foramen of Bochdalek is rare in right side of the diaphragm. Two cases of right Bochdalek hernia were reported in literatures published in Korea. The first case was associated with hypoplasia of the lung and could not be survived. The second case [four months old male infant] was operated on August 28, 1971. at Ewha University Hospital arid survived. The third case was a three months old male infant who had been born at 8th lunar month in a private clinic. During the period of three months prior to admission this premature infant was suf-fered from mild respiratory distress measured as pneumonia. On December 20. 1972, this infant was admitted at Kyung Hee University Hospital with severe respiratory distress developed abruptly. Chest X-ray examination [barium study] demonstrated right diaphragmatic hernia. Right hemithorax was filled with intestines and right lobe of the liver which were repositioned back into the peritoneal cavity through the foramen of Bochdalek. 3. 0 cm x3.5 cm in size, and the defect was closed with interrupt mattress sutures. There was hypospadia with chordee but no other associated anomalies such as hypoplasia of the lung, malrotation or malfixation of intestines, and cardiovascular anomalies. The Postoperative hospital course was not eventful and the baby was discharged on the 14th postoperative day.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.723-728
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• 1984

Congenital diaphragmatic hernia through of Bochdalek foramen, posterolateral diaphragmatic hernia, is the result of a congenital malformation of the posterolateral region of the diaphragm. Bochdalek hernia is not a rare anomaly and is the most common type of congenital diaphragmatic hernia. The defect is more frequently on left [about 5 times]. The purpose of this paper to present the Authors recent experience with two cases of the congenital posterolateral diaphragmatic hernia adult women which was treated surgically in the Dept, Thoracic Surgery, Chosun University Hospital. The postoperative course was uneventful and both of them were discharged without any other complications. Our study and surgical experience was discussed and the literature reviewed.

• Journal of Chest Surgery
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• v.28 no.9
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• pp.837-841
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• 1995

Between June 1981 and April 1994, 15 patients underwent surgical repair of diaphragmatic hernia. The ages ranged from 1 day to 60 years, with a mean age of 34. There were 5 cases of congenital diaphragmatic hernia; Bochdalek hernia in 4 cases and Morgagni hernia in 1 case. There were 10 cases of traumatic diaphragmatic hernia;blunt trauma in 8 cases and stab wounds in 2 cases. The chest X-ray findings were abnormal in 10 cases. Operations were performed in all patients and there was only one death, who was a newborn with left Bochdalek hernia and pulmonary hypoplasia.

• Journal of Chest Surgery
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• v.11 no.4
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• pp.433-440
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• 1978

Congenital diaphragmatic hernia is an important cause of respiratory distress in the newborn. Eventration, with which these conditions are easily confused, may also Produce severe respiratory distress in infancy or be an asymptomatic radiographic finding. Harrington`s classification of diaphragmatic hernias into two categories, traumatic and nontraumatic, is most widely accepted. Nontraumatic hernias are [1] the congenital types, composed of the posterolateral [Bochdalek], those through the esophageal hiatus, the parasternal [/Morgagni], and those through a defect left by partial absense posteriorly, and [2] the acquired types, composed of those through the esophagea/hiatus [sliding and paraesophageal] and those the sites mentioned above under the congenital hernias. During the period from 1970 up to October 1978, 21 cases of diaphragmatic hernia were treated in department of cardiovascular and thoracic surgery. 11 cases of Bochdalek hernias, 1 case of Morgagni hernia, 5 cases of diaphragmatic eventration and 3 cases of hiatal hernia [2 cases of paraesophageal and 1 cases of sliding type], were experienced. 3 cases of 20 died of respiratory insufficiency, 2 cases of mortality were combined with left lung hypoplasia with Bochdalek hernia.

• Journal of Chest Surgery
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• v.28 no.6
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• pp.640-643
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• 1995

Bochdalek hernia is the congenital posterolateral defect in the diaphragm caused by a failure of the pleuroperitoneal canal to close at 8 weeks, gestation. Infants with hernia diagnosed at birth have poor prognosis. Survival rate depends on pulmonary growth and development, preoperative stability and postoperative care. We experienced two cases of Bochdalek hernia, one in right was repaired with patch closure using sheet and the other in left was repaired with simple closure.

• Journal of Chest Surgery
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• v.19 no.2
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• pp.331-334
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• 1986

Bochdalek hernia in adult is relatively uncommon. We experienced a surgical case of Bochdalek hernia in a 29 year old housewife. She was admitted via E-R due to left chest pain and nausea for 1 months. 5 days before admission, she had Cesarean section on private hospital. After delivery, nausea and exertional dyspnea were aggravated. On admission, chest PA showed herniated stomach, colon, small intestine on left thorax. She was diagnosed of diaphragmatic hernia and operated. Operative findings were as follows: 1. hypoplastic: lower lobe of left lung, 2. stomach, colon, small intestine, spleen were herniated, 3. the defect was located on posterolateral portion of diaphragm, measuring 10 x 8 cm in size. Herniated intestines were reduced and diaphragmatic defect was repaired as interrupted sutures with 2-0 Mersilene. Postoperative courses were uneventful and the patient was discharged on POD 10th.

• Journal of Chest Surgery
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• v.15 no.4
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• pp.432-439
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• 1982

Congenital posterolateral diaphragmatic hernia [Bochdalek hernia] is the result of a congenital diaphragmatic defect in the posterior costal part of the diaphragm in the region of the tenth and eleventh ribs. There is usually free communication between the thoracic and abdominal cavities. The defect is most commonly found on the left [90%], but may occurs on the right, where the liver often prevents detection. The male to female ratio is 2:1. Owing to the negative intrathoracic pressure, herniation of abdominal contents through the defects occurs, with resultant collapse of the lung. Shifting of mediastinum to the opposite side and compression of the opposite lung occurs. Most often these hernias are manifestated by acute respiratory distress in the newborn. A second, but less well recognized, group of patient with Bochdalek hernia survive beyond the neonatal period, usually present at a later time with "failure of thrive, intermittent vomiting, or progressive respiratory difficulty. " The diagnosis can often be made on clinical ground from the presence of respiratory distress, absence of breath sounds on the chest presence of bowel sounds over the chest . Roentgenogram of the chest confirm the diagnosis. Obstruction and strangulation have been reported but are rare. Treatment consists of early reliable identification of these congenital diaphragmatic hernia with high risk and surgical repairment. and postoperative pharmacological management with extracorporeal membranous oxygenation [=ECMO] support in the period of intensive care. On the surgical approach, for defects on left side, an abdominal incision is preferred, because of the high incidence of malrotation and obstructing duodenal bands. In the neonate, the operative mortality may be appreciable, but, later repair almost always is successful. During the period from 1972 to 1982, 4 cases of congenital Bochdalek hernia were experienced at the Kyung-Hee University Hospital.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.729-734
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• 1984

Bochdalek hernia is a type of congenital diaphragmatic defect in the posterolateral portion of the diaphragm. The defect is usually Lt. sided due to protective effect of liver on right. Sex distribution is male preponderance [2:1] and it is diagnosed during neonate, mostly first 24 hours, due to severe respiratory distress. We experienced a rare case of old aged female patient with congenital Bochdalek hernia on Rt. side which was found incidentally during treatment of spontaneous pneumothorax of Rt. side. 17 year old female patient was admitted to CS department for chest discomfort on right and mild dyspnea with duration of 20 days. Under the diagnosis of spontaneous pneumothorax, Rt. closed thoracostomy and underwater sealed drainage with continuous suction was applied. On follow-up chest x-ray, poorly defined hazy increased density with multiple air-fluid levels in Rt. lower lung field and Lt. subphrenic free air were noted. So, Barium enema was done under the impression of Rt. diaphragmatic hernia, and nearly entire colon proximal to sigmoid was demonstrated in the Rt. hemithorax. Operation was done-for surgical repair of defected diaphragm through Rt. posterolateral thoracotomy. Operative findings were as follows; 1.Hypoplastic Rt. lung, esp. RML & RLL. 2.Nearly entirely intestines were herniated. 3.Diaphragmatic defect was located on posterolateral portion of the diaphragm, about 10x3cm in size with blunt smooth margin. 4.A large bleb on apex of RUL of lung. Herniated intestines were repaired into abdominal cavity manually and defect of diaphragm was repaired with No. I black silk interrupted sutures directly, and bleb was resected. Postoperative courses were uneventful and the patient was discharged with good condition on POD 14th.