Laparoscopic Repair for a Bochdalek Hernia in Young Person – Report of a Case

Atsushi Iida, MD PhD FACS, Katsusji Sawai, MDPhD, Mitsuhiro Morikawa, MD PhD, Takanori Goi, MD PhD, Kanji Katayama, MD PhD, Akio Yamaguchi, MD PhD. Gastroenterological surgery, University of Fukui



16-year-old female consulted our hospital by complaining continuous upper abdominal pain after her gymnastic activity. CT scan showed the protruded stomach and spleen to the left thoracic cavity by Bochdalek hernia. Emergent laparoscopic surgery was performed for the hernia. [Operative procedures] We set the trocar at the umbilicus for the scope and two trocars at upper abdomen for the surgeon. Nathason’s liver retractor was used for the liver retraction. The surgeon was standing between the legs of the patient, and the bed was tilted on head up position. There were protruded spleen, stomach and omentum into the left thoracic cavity seen through the hernia site by laparoscope. All surgical procedures were completed under laparoscopy that were the returning the protruded organs and the repairing the orifice of the hernia by sutures. The shrunken left lung was inflated just before the last suture for closing hernia site. There was no drain. [Results] The post-operative course was uneventful and the patient started to walk and to eat from the next day of the operation. The hospital stay was seven days. [Discussion and conclusion] The cases of Bochdalek hernia in adult were rarely reported. The reported severe cases with bowel obstruction or perforation were resulted in open surgery. Recent reports including our case indicate laparoscopic repair could be the good indication for the patients with Bochdalek hernia in the onset on adult. CT scan was useful to diagnose the Bochdalek hernia.

Session Number: Poster – Poster Presentations
Program Number: P282
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