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KMID : 0378020080510110055
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New Medical Journal
2008 Volume.51 No. 11 p.55 ~ p.59
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Bochdalek Hernia with Bowel Incarceration in Adult: A Case Report
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Lee Sang-Jin
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Abstract
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Bochdalek hernias are rare in adults. We report a case of Bochdalek hernia with bowel obstruction. A 71-year-old female with suddenly abdominal pain visited the emergency room of our hospital. Chest radiography showed air fluid level opacity in the left lower posterior thorax. Abdominal radiographs showed gaseous dilated colonic loops with large amount of fecal contents and focal semioval shaped air filled splenic flexure of colon in the left lower thorax. Pre- and post-contrast two phase dynamic multidetector computed tomography (MDCT) scans revealed defect of left diaphragmatic crus and herniated splenic flexure of colon with air fluid levels to left lower posterior thorax and marked dilated transverse colon and ascending colon and cecum. The patient received an emergency laparotomy, a Bochdalek hernia was found with diaphragm defect, 3×3 cm in size, with an irregular margin on the left posterior-lateral side of the diaphragm. Above the diaphragm, the splenic flexure of transverse colon was herniated. We pulled the tranverse colon back to the peritoneal cavity and repaired the diaphragmatic defect with sutures. The patient recovered well and was discharged 10days later after operation. We recommend that adult Bochdalek hernia should be considered in the differential diagnosis of bowel obstruction.
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KEYWORD
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Hernia, X-ary, Computed tomography
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