Background and Objectives: Bochdalek hernias are congenital diaphragmatic defects resulting from the failure of posterolateral diaphragmatic foramina to fuse in utero. Diagnosis of a Bochdalek hernia in an adult is rare and is typically observed on the left side of the diaphragm. Even more rare is the diagnosis of a symptomatic right-sided Bochdalek hernia in an adult, which generally presents with concurrent visceral involvement. We describe a case from our institution involving this rare defect.
Methods: A retrospective chart review was performed on a single patient for data collection purposes.
Results: The patient is a 77-year-old female with a history of symptomatic right posterior diaphragmatic hernia with incarcerated kidney causing hydronephrosis, as well as incarcerated colon and right posterior basilar atelectasis of the lung. Laboratory work up and imaging revealed no other findings. She has no other significant past medical or surgical history. Laparoscopic, hand-assisted repair of the Bochdalek hernia was done via abdominal approach with GoreTex mesh and V-Loc sutures. The patient has had significant clinical improvement and continues to do well 8 weeks post-operatively.
Conclusion: Laparoscopic, hand assisted repair of symptomatic adult Bochdalek hernias with Mesh can be performed successfully and may result in significant clinical improvement.