Congenital diaphragmatic hernia in adult.
A 34-year old man was admitted with sudden onset of chest pain and
vomiting. His symptoms were relieved after passage of a nasogastric tube.
Chest X-ray showed the stomach and colon in the left side of the chest.
He underwent laparoscopic reduction and repair of the diaphragmatic defect
(Bochdalek). The PA and lateral chest X-rays show the appearances two months after
laparoscopic repair of the defect. A surgical clip can be seen at the
site of operation.
Comment: most congenital diaphragmatic hernias (Morgagni, Bochdalek)
present in childhood. The literature contains less than 100 cases
reported of adult Bochdalek hernias. This is only the second
description of this type of hernial defect being sucessfully repaired
laparoscopically (Rice GD, O'Boyle CJ, Watson DI, Devitt PG, ANZ J
Surg, in press).
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