Dashti Faraj ,Emmy Janssen ,Harry van Goor ,Melanie Hartman ,Otmar R. Buyne ,Tina Natroshvili,
Right-Sided Bochdalek Hernia with Cecum Perforation
Surgical Case Reports
2020
2613-5965
http://dx.doi.org/10.31487/j.SCR.2020.03.04
https://www.sciencerepository.org/right-sided-bochdalek-hernia_SCR-2020-3-104 
Abstract: Background: A Bochdalek hernia is one of the most frequently occurring congenital diaphragmatic hernias,
and it occurs in 1 out of 2,500 births. Clinical cases of adults with symptomatic Bochdalek hernias are very
rare. We describe a patient with an incarcerated Bochdalek hernia who underwent emergency surgery and
presented with a recurrence after three years. Comparable cases in the literature were reviewed.
Case Presentation: A 56-year-old woman presented to the emergency department with acute dyspnea and
pain in the epigastrium shortly after gastroscopy. A CT scan showed right sided intrathoracic herniation of
the ascending colon and signs of perforation of a hollow viscus. During the operation, a suture repair of a
cecal perforation as well as of a diagrammatic lesion was performed. The thorax and abdomen were lavaged
and drained. The postoperative course was uneventful. After 3 years, the patient presented with colic pain
in the upper abdominal quadrants. A small recurrence of the Bochdalek hernia was observed on a computed
tomography scan and was managed with watchful waiting. A systematic search of comparable acute cases
of Bochdalek hernias was performed.
Conclusion: An incarcerated right colon with a perforation in a Bochdalek hernia is extremely rare; only
11 comparable cases of right sided Bochdalek hernia with acute symptoms are described in the literature.
Recurrent Bochdalek hernias are even rarer. As a delay in the diagnosis or a missed diagnosis can ultimately
lead to death, adequate imaging is warranted when considering a recurrence of a Bochdalek hernia.Keywords: Bochdalek hernia, intrathoracic cecum, cecum perforation, surgical repair