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A case of right-sided Bochdalek hernia incidentally diagnosed in a gastric cancer patient

BACKGROUND: Bochdalek hernia (BH) is generally congenital, presenting with respiratory distress. However, this pathology is rarely detected in adults. Some adult cases of BH present with symptoms attributed to the hernia, but incidental detection of BH is increasing among asymptomatic adults due to...

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Autores principales: Kikuchi, Satoru, Nishizaki, Masahiko, Kuroda, Shinji, Kagawa, Shunsuke, Fujiwara, Toshiyoshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4888207/
https://www.ncbi.nlm.nih.gov/pubmed/27245581
http://dx.doi.org/10.1186/s12893-016-0145-2
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author Kikuchi, Satoru
Nishizaki, Masahiko
Kuroda, Shinji
Kagawa, Shunsuke
Fujiwara, Toshiyoshi
author_facet Kikuchi, Satoru
Nishizaki, Masahiko
Kuroda, Shinji
Kagawa, Shunsuke
Fujiwara, Toshiyoshi
author_sort Kikuchi, Satoru
collection PubMed
description BACKGROUND: Bochdalek hernia (BH) is generally congenital, presenting with respiratory distress. However, this pathology is rarely detected in adults. Some adult cases of BH present with symptoms attributed to the hernia, but incidental detection of BH is increasing among asymptomatic adults due to advances in imaging modalities. This report presents the management of incidental BH patients detected in the preoperative period of gastric cancer. CASE PRESENTATION: An asymptomatic 76-year-old woman was diagnosed with advanced gastric cancer during follow-up after radiotherapy for uterine cervical cancer. Computed tomography (CT) was performed to exclude metastatic gastric cancer, incidentally detecting right-sided BH. We planned distal gastrectomy with lymph node dissection for gastric cancer and simultaneous repair of BH using a laparoscopic approach. We performed laparoscopic gastrectomy for gastric cancer and investigated the right-sided BH to assess whether repair during surgery was warranted. Herniation of the liver into the right hemithorax was observed, but was followed-up without surgical repair because the right hepatic lobe was adherent to the remnant right anterior hemidiaphragm and covered the huge defect in the right hemidiaphragm. No intra- or postoperative pneumothorax was observed during pneumoperitoneum. CONCLUSION: Regardless of symptoms, repair of adult BH is generally recommended to prevent visceral incarceration. However, BH in asymptomatic adults appears to be more common than previously reported in the literature. Surgeons need to consider the management of incidental BH encountered during thoracic or abdominal surgery.
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spelling pubmed-48882072016-06-02 A case of right-sided Bochdalek hernia incidentally diagnosed in a gastric cancer patient Kikuchi, Satoru Nishizaki, Masahiko Kuroda, Shinji Kagawa, Shunsuke Fujiwara, Toshiyoshi BMC Surg Case Report BACKGROUND: Bochdalek hernia (BH) is generally congenital, presenting with respiratory distress. However, this pathology is rarely detected in adults. Some adult cases of BH present with symptoms attributed to the hernia, but incidental detection of BH is increasing among asymptomatic adults due to advances in imaging modalities. This report presents the management of incidental BH patients detected in the preoperative period of gastric cancer. CASE PRESENTATION: An asymptomatic 76-year-old woman was diagnosed with advanced gastric cancer during follow-up after radiotherapy for uterine cervical cancer. Computed tomography (CT) was performed to exclude metastatic gastric cancer, incidentally detecting right-sided BH. We planned distal gastrectomy with lymph node dissection for gastric cancer and simultaneous repair of BH using a laparoscopic approach. We performed laparoscopic gastrectomy for gastric cancer and investigated the right-sided BH to assess whether repair during surgery was warranted. Herniation of the liver into the right hemithorax was observed, but was followed-up without surgical repair because the right hepatic lobe was adherent to the remnant right anterior hemidiaphragm and covered the huge defect in the right hemidiaphragm. No intra- or postoperative pneumothorax was observed during pneumoperitoneum. CONCLUSION: Regardless of symptoms, repair of adult BH is generally recommended to prevent visceral incarceration. However, BH in asymptomatic adults appears to be more common than previously reported in the literature. Surgeons need to consider the management of incidental BH encountered during thoracic or abdominal surgery. BioMed Central 2016-06-01 /pmc/articles/PMC4888207/ /pubmed/27245581 http://dx.doi.org/10.1186/s12893-016-0145-2 Text en © Kikuchi et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Kikuchi, Satoru
Nishizaki, Masahiko
Kuroda, Shinji
Kagawa, Shunsuke
Fujiwara, Toshiyoshi
A case of right-sided Bochdalek hernia incidentally diagnosed in a gastric cancer patient
title A case of right-sided Bochdalek hernia incidentally diagnosed in a gastric cancer patient
title_full A case of right-sided Bochdalek hernia incidentally diagnosed in a gastric cancer patient
title_fullStr A case of right-sided Bochdalek hernia incidentally diagnosed in a gastric cancer patient
title_full_unstemmed A case of right-sided Bochdalek hernia incidentally diagnosed in a gastric cancer patient
title_short A case of right-sided Bochdalek hernia incidentally diagnosed in a gastric cancer patient
title_sort case of right-sided bochdalek hernia incidentally diagnosed in a gastric cancer patient
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4888207/
https://www.ncbi.nlm.nih.gov/pubmed/27245581
http://dx.doi.org/10.1186/s12893-016-0145-2
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