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Two cases of laparoscopic repair of Bochdalek hernia in adults Nobuyoshi ASOU 1 , Toshiyuki MORI 1 , Masaharu KOGURE 1 , Yoshikazu HASHIMOTO 1 , Tadahiko MASAKI 1 , Masanori SUGIYAMA 1 1Department of Surgery, Kyorin University School of Medicine Keyword: Bochdalek孔ヘルニア , 横隔膜ヘルニア , 腹腔鏡下手術 pp.527-536
Published Date 2018/7/15
DOI https://doi.org/10.11477/mf.4426200583
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Adult Bochdalek hernia occurs infrequently. Although the defect in the left-posterior diaphragm is congenital, only 10% of Bochdalek hernias reportedly become evident after childhood. Here, we present two cases of adult Bochdalek hernia repaired laparoscopically. Case 1: A 16-year-old woman presented with left lateral abdominal pain during exercise. CT scan showed her stomach and colon herniating into the thoracic cavity via a hernia orifice located in the dorsal side of the left diaphragm, and she was diagnosed as having adult Bochdalek hernia. The hernia orifice was successfully closed via a laparoscopic suturing technique. Case 2: A 71-year-old woman with a history of splenectomy due to immune thrombocytopenia presented with left hypochondriac pain. CT scan showed massive herniation of several abdominal visceral organs, including the left superior pole of the left kidney, pancreatic body and tail, and transverse colon, into the thoracic cavity. Laparoscopic surgery was conducted, and a slit-shaped hernia orifice was identified in the left vertebrocostal trigone of the diaphragm, which is compatible with a diagnosis of Bochdalek hernia. The hernia orifice was probably missed during the previous splenectomy. The viscera was successfully reduced to the abdominal cavity, and the hernia orifice was sutured closed. Both patients experienced an uneventful postoperative course, and recurrence of hernia has not been noted to date.


Copyright © 2018, 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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