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Laparoscopic surgery for adult Bochdalek's hernia with difficulties : report of a case Takashi YOKOYAMA 1 , Akihiko WATANABE 1 , Kenji NAKAGAWA 1 , Takashi INOUE 1 , Kazuhiro MIGITA 1 , Tomohide MUKOGAWA 1 , Takao OHYAMA 1 , Hirofumi ISHIKAWA 1 1Department of Surgery, Nara Prefectural Nara Hospital Keyword: 成人Bochdalek孔ヘルニア , 腹腔鏡下手術 , MDCT(multidetector-row CT) pp.725-732
Published Date 2009/12/15
DOI https://doi.org/10.11477/mf.4426100416
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 A 37-year-old man was seen at the hospital because of cough, left chest pain, breathing difficulty, and fever. A chest X-ray film showed an abnormal shadow in the left lower lobe, and multidetector-row computed tomography(MDCT)showed the presence of a left-sided diaphragmatic hernia and incarceration of abdominal fat tissue. He was admitted to our hospital and laparoscopic repair was performed. The greater omentum was herniated into the left thoracic cavity through a dorsolateral defect of the left diaphragm(Foramen Bochdalek). The omentum was pulled back in to the peritoneal cavitiy. Because it is difficult to suture the hernia orifice by laparoscopic maneuver, laparotomy was performed and the orifice was directly closed using absorbable surgical sutures. He made an uneventful recovery and remains well at 15-month follow-up. MDCT was very useful in diagnosis. Laparoscopic procedure is proving to be more beneficial than laparotomy or thoracotomy, however, several devices are required in order to overcome the difficulties.


Copyright © 2009, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.

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電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

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