Congenital right bochdalek hernia presenting as emergency in old age: A case report

Abstract

Congenital diaphragmatic hernias (CDHs) are known to present even after the neonatal period. Posterolateral Bochdalek hernias account for the majority of cases. About 85% tend to occur on the left side, while the right side accounts for roughly 13% of the cases. We present a case of a right-sided Bochdalek hernia in an elderly man who was asymptomatic for 60 years of life. The patient presented with vague right upper abdominal discomfort, and ultrasound abdomen revealed herniation of the small bowel into right hemithorax, showing sluggish peristalsis, raising a suspicion of impaired vascularity. He subsequently underwent contrast CT, which confirmed herniation of small bowel loops into right thorax with normal vascularity but dilatation of bowel loops and a possibility of closed-loop obstruction. He was taken up for emergency surgery. The patient had uneventful recovery. © Association of Surgeons of India 2012.