AUTHOR=Ramspott Jan Philipp , Regenbogen Stephan , Jäger Tarkan , Lechner Michael , Mayer Franz , Gabersek Ana , Emmanuel Klaus , Schredl Philipp TITLE=Case Report: Adult Right-Sided Bochdalek Hernia Complicated by Intrathoracic Bowel Perforation JOURNAL=Frontiers in Surgery VOLUME=8 YEAR=2021 URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2021.755279 DOI=10.3389/fsurg.2021.755279 ISSN=2296-875X ABSTRACT=

Right-sided Bochdalek hernia is a mostly congenital condition of the diaphragm caused by a persistence of the pleuroperitoneal cavity and a rare disease in adults. As it often presents as an emergent situation, urgent diagnostics and surgical intervention are essential to reduce morbidity and mortality rates. Choosing the right surgical approach (abdominal, thoracic, or a combination of both) can be very challenging for clinicians. Here, we report a case of a 40-year-old woman, who presented with severe abdominal pain and tachypnoea. Imaging revealed a right-sided Bochdalek hernia. Emergency laparotomy was performed followed by reduction of hernia content, right-sided hemicolectomy, and side-to-side anastomosis from the ileum to the transverse colon due to intestinal ischemia and intrathoracic bowel perforation. The post-operative course was complicated by a pleural empyema. Therefore, the patient underwent thoracotomy. One year after surgical repair the patient had no recurrence. Here, we discuss feasible approaches for the surgical management of complicated Bochdalek hernias.