Bochdalek hernia develops from mal-development in the fusion of the cephalic fold of the pleuroperitoneal membrane. It was first described by Bochdalek in 1848. It is most frequently diagnosed in neonates or children, while its presence in adult is rare. Perforation or necrosis of the involved organ is a feared complication and surgical repair constitutes the gold standard of treatment. Cadaveric examination discovered 1 in 7000. Yet, other attempts to study the incidence of Bochdalek hernia based on prospective CT studies found the incidence of about 13%.
Here, we present a 42 year old male who presented with left flank pain, nausea, and vomiting. Initial CT was interpreted as upside down stomach and a hiatal hernia. During laparoscopy, the stomach, greater omentum, and the transverse colon were herniated through the defect into the right chest cavity. The defect measure about 13 cm in length. Fresh edges were initially obtained in order to anchor the mesh and the defect we closed primarily. A Gore-Tex soft mesh is placed with the ePTFE side facing the viscera.
Post operatively, the patients symptoms resolved completely and was discharged the following day. Laparoscopic repair of Bochdalek hernia by closing the defect primarily and utilizing mesh is an effective and a safe approach.
Session: Podium Video Presentation
Program Number: V011